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目的探讨阿奇霉素联合糖皮质激素治疗小儿重症支原体肺炎的疗效。方法将小儿重症支原体肺炎患儿60例随机分为观察组和对照组各30例。对照组采用阿奇霉素序贯治疗;观察组在对照组基础上联合糖皮质激素序贯治疗。比较2组患儿发热、咳嗽、肺部啰音消退及胸片恢复时间,不良反应及治疗效果。加强患儿病情的随访,记录治疗后2个月期间病情复发情况。结果经治疗,观察组患儿发热、肺部啰音、咳嗽各临床主要症状消退所需时间均显著短于对照组,胸片恢复所需时间同样显著短于对照组,差异均有统计学意义(P<0.05)。观察组临床治疗总有效率为93.3%高于对照组的76.7%,差异有统计学意义(P<0.05)。治疗期间2组均无不良反应的发生。对照组患儿在治愈出院后的2个月随访期间,观察组患儿病情复发率为3.3%(1/30)低于对照组的23.3%(7/30),差异有统计学意义(χ2=6.264,P<0.05)。结论临床治疗小儿重症支原体肺炎采用阿奇霉素序贯疗法联合糖皮质激素,可显著提高临床治疗有效率,显著缩短发热、咳嗽、肺部啰音、胸片恢复所需时间,降低病情复发率,且临床应用无不良反应发生,具有显著推广应用价值。
Objective To investigate the efficacy of azithromycin combined with glucocorticoid in the treatment of pediatric severe mycoplasma pneumonia. Methods Sixty children with severe Mycoplasma pneumonia in children were randomly divided into observation group and control group, 30 cases each. The control group was treated with azithromycin sequential therapy. The observation group was treated with glucocorticoid sequential therapy on the basis of the control group. The fever, cough, pulmonary rales, recovery time of chest radiograph, adverse reactions and therapeutic effects were compared between the two groups. To strengthen the follow-up of children’s condition, record the recurrence of the disease after 2 months of treatment. Results After treatment, the time required for fever, pulmonary rales and cough in major clinical symptoms to disappear in the observation group was significantly shorter than that in the control group, and the time required for chest X-ray recovery was also significantly shorter than that in the control group, with significant differences (P <0.05). The total effective rate of clinical observation in observation group was 93.3%, which was significantly higher than 76.7% in control group (P <0.05). No adverse reactions occurred in the two groups during the treatment. In the control group, the recurrence rate of children in the observation group was 3.3% (1/30) less than that of the control group (23/30%, 7/30) during the follow-up period of 2 months after cure and discharge, the difference was statistically significant (χ2 = 6.264, P <0.05). Conclusion Clinical treatment of severe mycoplasma pneumonia in children with azithromycin sequential therapy combined with glucocorticoid, can significantly improve the efficiency of clinical treatment, significantly reduce the fever, cough, pulmonary rales, chest X-ray recovery time and reduce the recurrence rate, and clinical Application No adverse reactions, with significant promotion and application value.