目的：探讨儿童肺炎支原体（ MP)感染相关心包积液的临床特点,提高对该病的诊治水平。方法回顾2008年1月—2014年12月我院收治的儿童MP感染相关心包积液8例的临床资料,对临床特点、医技检查、治疗方法进行分析。结果8例均急性发病,有发热,咳嗽、气促4例,胸痛、胸闷3例,食欲缺乏1例。就诊初期6例诊断不明确,曾考虑心功能不全3例,川崎病2例,幼年特发性关节炎1例。8例心包积液均由超声心动图检查证实,其中2例因大量心包积液引起压迫症状行心包穿刺抽液处理。均经查血清MP-IgM抗体阳性明确诊断,全部予静脉-口服阿奇霉素序贯疗法治疗,6例痊愈出院,2例好转出院。出院后7例获随访,随访时间3~47个月,无一例复发。结论MP相关心包积液临床相对少见,易与其他导致心包积液的疾病相混淆而误诊,及时应用阿奇霉素疗效及预后均较好。%Objective To investigate the characteristics of pericardial effusion associated with mycoplasma pneumonia ( MP) infection in children. Methods Clinical data of eight cases with pericardial effusion associated with MP during Jan. 2008 and Dec. 2012, including clinical characteristics,accessory examinations and therapies,were collected and analyzed. Re-lated literature was reviewed. Results Eight patients ran a fever, and all the patients had a history of acute onset,four pa-tients had a cough and dyspnea, and three patients had stethalgia and chest stuffiness, and one patient had a poor appetite. Six patients were not clear in the early diagnosis. There were three patients once suspected with cardiac failure, two patients of Kawasaki disease and one patient of juvenile idiopathic arthritis. Eight patients with pericardial effusion were confirmed by ul-trasonic cardiogram. Pericardiocentesis and drainage were performed on 2 patients of children with pressure symptoms caused by quantity pericardial effusion. The serum antibodies of MP IgM were positive to make a definite diagnosis for all cases. All the children were treated with intravenous oral Azithromycin sequential therapy. Six patients recovered and two were cured, and discharged from hospital. Seven patients were followed up for 3-47 months after discharge from the hospital, and there was no relapsed. Conclusion Pericardial effusion associated with mycoplasma pneumoniae( MP) infection in children is relatively uncommon, and may be easily confused with other cause of pericardial effusion diseases, which may lead to misdiagnosis, and the effect of timely Azithromycin treatment is good for prognosis.
展开▼
