儿童支原体肺炎的发病特点调查分析

发布时间：2018-03-09 17:07

本文选题：小儿　切入点：支原体肺炎　出处：《吉林大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：本研究探讨小儿肺炎支原体肺炎的发病的流行病学与临床特点，为该病的预防提供有益的参考。方法：回顾性地对2009年12月份～2011年12月份以肺炎诊断收住吉林大学第三临床医院儿科的197例肺炎支原体肺炎患儿的发病特点、临床症状、体征、辅助检查资料、肺外并发症、治疗及转归进行分析。结果：1.4岁以上年龄段支原体肺炎，病例占同年龄段肺炎总病例数23.60%以上，显著高于3岁以内小儿（P=0.0004）。2.小儿支原体肺炎以秋、冬季发病显著高于其他季节。3.男女两性发病比率无显著差异4.本组支原体肺炎患儿中约89%的患儿均有不同程度发热，且年龄越小，发热率越高，全部婴儿患者出现发热；年龄越小，发热程度越高，婴儿患者有近一半的病例。各年龄段在发热率和发热程度上存在统计学意义的显著性差异，(2=20.66，P=0.0081)。5.学龄前和婴幼儿患者刺激性干咳的发生率波动在23%～32.5%之间，年长儿刺激性干咳发生率为67.5%，青春期组达89.19%，不同年龄间刺激性干咳的发生率存在统计学意义的显著性差异(2=122.27，P0.0001)。6.幼儿和学龄前儿童咳痰发生率分别为48.15%和65%，明显高于学龄儿童和婴儿，但是有69.24%的婴儿有喉头痰鸣，占有该症状全部19例患儿的47.37%(P0.0001）。7. WBC10×109/L者仅占全部病例的30.46%，67.01%病儿的外周血白细胞在正常范围。8.62.44%的患儿血清C反应蛋白(CRP)在正常范围内；但是各年龄组患儿C反应蛋白升高的比率有显著性差异，(2=35.42P＜0.0001)，年长儿升的比率高明显高于低龄儿。9.影像学检查显示，所有患儿均有肺部影像学改变,肺部影像学表现呈多样性,婴幼儿以斑片状阴影多见,学龄儿童出现节段性、大片状阴影较常见（2=42.38，P=0.0001）。10.肺外并发症者的发生率较低，仅有37.05%。11.小儿支原体肺炎对阿奇霉素敏感，197例全部治愈出院，住院时间平均14.6天。结论: 1.发热是支原体肺炎的主要症状，且年龄越小，，发热率越高；年龄越小，发热程度也越高； 2.年长儿多有刺激性干咳；年幼儿多有咳痰； 3.虽然所有患儿均有肺部影像学改变，但是听诊有肺部罗音者仅为18.78%； 4.小儿支原体肺炎对阿奇霉素敏感；
[Abstract]:Objective: to investigate the epidemiology and clinical characteristics of mycoplasma pneumoniae pneumonia in children, and to provide useful reference for the prevention of mycoplasma pneumoniae pneumonia. Methods: from December 2009 to December 2011, 197 cases of mycoplasma pneumoniae pneumonia in pediatrics of the third Clinical Hospital of Jilin University were retrospectively analyzed. Treatment and outcome were analyzed. Results Mycoplasma pneumonia in the age group over 1.4 years old accounted for more than 23.60% cases of pneumonia in the same age group, which was significantly higher than that in children under 3 years old. The incidence rate in winter was significantly higher than that in other seasons. There was no significant difference between male and female. 4. About 89% of the children with mycoplasma pneumonia had different degrees of fever, and the younger the age, the higher the fever rate, and all the infants had fever. The younger the age, the higher the degree of fever, and nearly half of the cases were infantile. There were statistically significant differences in fever rate and fever degree between different age groups. The incidence of irritating dry cough in preschool and infant patients fluctuated between 23% and 32.5%. The incidence of irritating dry cough was 67.5% in the older infants and 89.19 in the puberty group. There was a significant difference in the incidence of irritating dry cough between different ages. The incidence of sputum in infants and preschool children was 48.15% and 65, respectively, which was higher than that in preschool children. Children and infants of school age, However, 69.24% infants had laryngeal phlegm, 47.37% of the 19 children with this symptom had P0.0001 / L, 7.The WBC10 脳 10 9 / L group accounted for only 30.46% of all cases. The peripheral blood leukocytes of 67.01% of the children were in the normal range. 8.62.44% of the children had the normal range of serum C-reactive protein (C-reactive protein). However, there was significant difference in the ratio of elevated C-reactive protein among different age groups (P < 0.0001, P < 0.0001). The rate of elevation of C-reactive protein in older children was significantly higher than that in low-age children. Imaging examination showed that all children had pulmonary imaging changes, and the imaging manifestations of lung were diverse. The incidence of extrapulmonary complications was lower in children with extrapulmonary complications, only 37.05 .11.The children with mycoplasma pneumonia were all cured of azithromycin in 197 cases. The average hospital stay was 14.6 days. Conclusion:. 1. Fever is the main symptom of mycoplasma pneumonia, and the younger the age, the higher the fever rate, the lower the age, the higher the degree of fever. 2. The older children have irritating dry cough, and the young children have expectoration. 3. Although all children had lung imaging changes, only 18.78 patients had lung rales at auscultation. 4. Mycoplasma pneumonia in children was sensitive to azithromycin;
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6

【参考文献】