【目的】 通过对肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)并发肺不张患儿1年后胸部高分辨CT(high-resolution computed tomography,HRCT)、肺功能的随访,分析患儿住院期间的临床特点,寻找发生肺部并发症的易患因素。 【方法】 回顾性分析北京儿童医院2006年5月-2007年5月1 166例住院治疗的MPP患儿的临床资料,其中恢复期肺不张的患儿109例,在出院后1.0~1.4年,取得家长同意,通过电话预约为患儿复查胸部HRCT及肺功能,接受随访的病人共36例。 【结果】 1)不同年龄之间MPP并发肺不张的检出率比较差异无统计学意义(P＞0.05);2)36例肺不张患儿胸部HRCT检测仍存在肺部异常情况有23人,占63.9%;3)依据MPP并发肺不张患儿胸部HRCT表现正常与否,分为异常HRCT组和正常HRCT组,患儿住院期间的临床特点比较,起病年龄、发热及咳嗽持续时间、应用纤维支气管镜灌洗治疗的早晚四项两组比较差异有统计学意义(P＜0.05);4)随访27例患儿肺功能,阻塞性通气功能障碍16例,混合性通气功能障碍,以阻塞为主1例。 【结论】 MPP患儿发热、咳嗽时间长,年龄较小易发生肺部并发症,需早期行纤维支气管镜灌洗治疗,定期随访肺功能。

【Objectives】 To analyze the clinical features in the recovery phase of mycoplasma pneumoniae pneumonia(MPP) with pulmonary atelectasis complication and to evaluate the factors of sequelae may occur after mycoplasma pneumoniae pneumonia by analysis of the examinations of high-resolution computed tomogramphy (HRCT) and pulmonary function. 【Methods】 109 cases of pediatric MPP with pulmonary atelectasis complication had been selected from 1 166 patients who were treated in Beijing Pediatric Hospital between May 2006 and May 2007.After telephone appointments and parental authorizations,thirty-six children were examined with HRCT and/or with pulmonary function after an interval of 1.0 to 1.4 years. 【Results】 1)The incidence of pediatric MPP with pulmonary atelectasis complication in hospitalized patients was no significant difference in age distributions (P>0.05).2) 23 patients had been identified with abnormal lung appearance by using HRCT imaging in 36 cases of pediatric MPP with pulmonary atelectasis complication,corresponding to a rate of 63.9%.3)The patients were divided into "Abnormal HRCT Group" and "Normal HRCT Group" according to their HRCT examinations.Comparative studies were carried out between two groups,and showed significant differences (P<0.05) in age distribution,duration of fever and cough.There was a significant difference in the therapeutically effect of fiber-optical bronchoscope-assisted washing treatment between the group within 20 days and more than 20 days of illness (P<0.05).4) The pulmonary functions in 27 cases were still abnormal with obstruction of ventilation function in 16 cases and with complexed/mixed ventilation functional obstructions with blocking as primary obstacle in 1 case. 【Conclusions】 Careful follow-up is important for mycoplasma pneumonia in younger children or fever and cough is longer.Early applying the fiber-optical bronchoscope-assisted washing treatment may reduce the sequelae.The pulmonary function should be examined with regular.