Clinical Analysis Of Severe Mycoplasma Pneumoniae Pneumonia In Children In Guangyuan City

Objective:To investigate the clinical characteristics and treatment of severe Mycoplasma pneumoniae pneumonia(SMPP)in children,so as to improve the diagnosis and treatment level of SMPP.Methods:From June 2018 to June 2020,62 cases of pediatric inpatients in Guangyuan Central Hospital and Guangyuan first people’s hospital were selected,which met the diagnostic criteria of SMPP,and their general data(gender,age),onset season and clinical manifestations(such as cough,fever,etc.),laboratory examination(such as white blood cell number,C-reactive protein,calcitonin,etc.),complications(such as pericardial effusion,pleural effusion,peritoneal effusion,myocardial damage,liver damage,electrolyte disorder,skin rash,etc.),treatment(such as the application of azithromycin,glucocorticoid,gamma globulin,pleural puncture,ventilator support,etc.),hospitalization time and outcomewere retrospectively analyzed.Results:In 62 cases of SMPP,preschool and school-age children accounted for a high proportion(preschool children accounted for 33.87%,school age children accounted for 41.94%),and the incidence rate was high in autumn and winter(29.03%in autumn and 46.77%in winter).The main clinical manifestations were cough,fever and shortness of breath.The inflammatory indexes were increased in most cases.The main imaging findings were massive high-density shadow(100%)and pulmonary consolidation(67.74%),pleural effusion(22.58%),atelectasis(12.9%),bronchial stenosis(3.23%),etc.Some of them had extrapulmonary manifestations such as liver damage,electrolyte disorder,myocardial damage,skin rash,pericardial effusion and ascites.All the children were treated with macrolide(azithromycin),the cure rate and the rate of hospital stay≤10 days of azithromycin treatment within 7 days of onset were higher than those of azithromycin treatment after 7 days of onset,and the difference was significant(P<0.05).35 cases(56.45%)were treated with glucocorticoid,Compared with the non hormone group,the cure rate and the rate of hospital stay ≤10 days in the hormone group were significantly higher than those in the non hormone group(P<0.05).Most of the patients were treated with other broad-spectrum antibiotics(such as cefoperazone sodium,sulbactam sodium,cefotaxime sodium,sulbactam sodium,meropenem sodium,meropenem sodium,etc.).5 cases(8.06%)were treated with gamma globulin.Another 2 cases were given noninvasive ventilator assisted breathing,and 1 case was given thoracentesis and closed thoracic drainage.Except that 5 cases were transferred to the superior hospital for further treatment,the other cases were cured or improved after symptom control.Conclusion:The incidence rate of SMPP is related to age and season.The clinical symptoms were severe,the imaging examination showed that the lung lesions were obvious,and it was easy to be complicated with complications inside and outside the lung.Early administration of macrolides for anti infection and combined with glucocorticoid anti-inflammatory can improve the cure rate and shorten the course of disease.After reasonable and effective treatment,the prognosis of most patients is good.