95 cases by lavage mycoplasma pneumonia clinical research
|School||Dalian Medical University|
|Keywords||Mycoplasma pneumoniae Bronchoalveolar lavage Clinical features Child|
Objective: Mycoplasma pneumoniae (Mycoplasma pneumoniae, MP) among children with community-acquired pneumonia is one common cause. Typically mycoplasma pneumonia (Mycoplasma Pneumoniae Pneumonia, MPP) in children with mild clinical symptoms, the treatment well, but there are also some children with clinical symptoms and treatment difficulties, which we took a bronchial lavage, a comprehensive analysis of this group of mycoplasma pneumonia clinical characteristics and on its different degrees of lung damage be explored differences in clinical manifestations, increasing clinician awareness of this group of diseases, treatment programs for early identification, reducing lung damage provide some guidance. Methods: A retrospective analysis of October 2008 - September 2010 Dalian Children's Hospital Respiratory 95 cases bronchoscopic lavage MPP children with clinical data, summarize the clinical manifestations, laboratory examination, chest radiography, bronchoscopy and treatment, prognosis. And based on the severity of their chest radiographs were divided into two groups (mild lung damage group: single lobe involvement; severe lung damage group: two or more lung involvement and (or) with pleural effusion), analysis of the clinical features and test results relationship with the severity of lung damage. Results: The average age of children with MPP 6.57 ± 2.64 years, an average of fever 16.29 ± 7.07 days, the average length of stay 18.30 ± 5.82 days. 19 cases (20%) patients had pulmonary symptoms, pulmonary symptoms in patients with myocardial damage based, and there are five cases of multiple organ dysfunction syndrome. 40 cases (42.1%) children with a mixture of bacteria and (or) virus infection. Chest imaging are manifested as one or more lobes / segmental lung consolidation, large density shadow or parenchymal infiltrates. 58 cases (61.1%) patients with severe lung damage, including pleural effusion in children with 49 cases (51.6%), pleurisy 25 cases (26.3%), multi-lobe involvement in 47 cases (49.5%), while atelectasis 34 cases (35.8%). Bronchoscopy lesions are visible mucosal congestion, edema and increased secretions, other luminal swelling, tube ridge widened in 68 patients (71.6%), lung segments / sub-segmental bronchi see necrotic material blocking the nozzle 27 cases (28.4% ). 28 cases (29.5%) patients using intravenous glucocorticoid therapy, including 17 cases (17.9%) patients with glucocorticoids in Canada after 1 to 3 days fever, 42 cases (44.2%) patients in the first a second bronchoscopy 1 to 3 days after treatment, fever. Prognosis shows 73.5 percent of atelectasis in children basic recruitment, 35.8% of children most or pulmonary infiltrates have been completely absorbed. Children with severe lung damage group of C-reactive protein (CRP) values ??higher than mild damage group (Ρ = 0.02). Severe lung damage and pulmonary symptoms in children with MP-IgM antibody overcast sun more common (Ρ = 0.04, Ρ = 0.04), mixed bacterial infection in patients with fever longer than the mere MP infection (Ρ = 0.04). Conclusion: This study of patients with older children MPP common; 2 cases a higher proportion of mixed infections, bacterial infection in children with prolonged fever, persistent disease is caused by one of the factors; 3. Joint use of large macrolide antibiotics and bronchoalveolar lavage therapy and prognosis, hormone also showed positive short-term effects; 4 children with severe lung damage and the combined CRP levels were significantly increased pulmonary symptoms and serum MP-IgM antibody seroconversion positive performance of common, indirectly suggest MPP severe lung damage directly after the invasion of infection and immune disorders become more pronounced.