唐月静

[摘要] 目的 探究小儿难治性支原体肺炎应用甲泼尼龙联合阿奇霉素治疗的疗效及安全性。方法 方便选择东海县人民医院2014年1月—2016年12月收治的108例小儿难治性支原体肺炎患儿，随机分为观察组和对照组，各54例，对照组单纯给予阿奇霉素，观察组应用甲泼尼龙联合阿奇霉素治疗，比较两组患儿治疗后临床症状情况、疗效和不良反应。结果 观察组治疗后退热时间（7.20±1.33）d，CBP水平（12.33±5.44）mg/L，咳喘消失时间（9.22±1.07）d，肺部啰音消失时间（8.52±0.75）d显著优于对照组（P<0.05）；观察组总有效率92.59%显著高于对照组72.22%（P<0.05）；对照组不良反应发生率为7.40%，觀察组为5.56%，差异无统计学意义（P>0.05）。结论 对小儿难治性支气管肺炎患儿以甲泼尼龙联合阿奇霉素治疗，效果好，安全性好。

[关键词] 小儿难治性肺炎；甲泼尼龙；阿奇霉素；疗效；安全性

[中图分类号] R974 [文献标识码] A [文章编号] 1674-0742（2018）01（a）-0139-03

Efficacy and Safety of Methylprednisolone Combined with Azithromycin in the Treatment of Refractory Mycoplasma Pneumonia （RMPP） in Children

TANG Yue-jing

Childrens Health Management Department， Lianyungang Maternity and Child Hospital， Lianyungang， Jiangsu Province， 222100 China

[Abstract] Objective This paper tries to explore the efficacy and safety of methylprednisolone combined with azithromycin in children with refractory mycoplasma pneumonia. Methods A total of 108 children with refractory mycoplasma pneumonia were conveniently enrolled in Donghai County Peoples Hospital from January 2014 to December 2016. They were randomly divided into observation group and control group， with 54 patients in each group. The control group was given azithromycin only. The observation group was treated with methylprednisolone combined with azithromycin. The clinical symptoms， curative effects and adverse reactions of the two groups were compared. Results The antipyretic time in the observation group was（7.20±1.33）d， CBP（12.33±5.44）mg/L， the time of disappearance of cough and asthma（9.22±1.07）d， the time of disappearance of rales（8.52±0.75）d， better than the control group （P<0.05）. The total effective rate was 92.59% in the observation group and higher than the control group of 72.22%（P<0.05）. The adverse reaction rate was 7.40% in the control group and 5.56% in the observation group，the difference was not statistically significant（P>0.05）. Conclusion Pediatric refractory bronchial pneumonia in children with methylprednisolone combined azithromycin treatment has good efficiency and safety.

[Key words] Children with refractory pneumonia； Methylprednisolone； Azithromycin； Efficacy； Safety

小儿支原体肺炎是小儿呼吸系统的常见病和多发病，是由于感染肺炎支原体导致，可在任何季节发生[1]。小儿支原体肺炎可导致患者出现呼吸困难、咳喘、发烧等临床症状，随着病情进展可对患者呼吸系统造成严重损伤，引发患者出现呼吸窘迫、呼吸衰竭、窒息等危险，具有较高的风险性[2]。因此，小儿支原体的治疗关键在于及时有效的杀菌治疗，控制患者病情进展[3]。在小儿支原体肺炎患儿早期治疗中，由于支原体无法监测，临床将大环内酯类抗生素作为治疗的首选药物。临床研究指出[4]，阿奇霉素联合甲泼尼龙治疗具有较好的抑菌、消炎、抗感染作用，在有效控制感染、抑制支原体繁殖的治疗中对患儿的器官功能损伤较小，在小儿支原体肺炎治疗中具有较高的安全性。……