孩子得了支原体肺炎如何治疗

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医院儿科：郭道茂

什么是支原体：支原体是一种比细菌小、又比病毒大的微小微生物，它是最小的能独立生活的原核生物，但又具有某些细菌的特性。

什么是支原体肺炎：有一种肺炎支原体是引起儿童肺炎的常见病原体。年新出现的SARS病毒引起的非典，其实是因为一开始病因不明，才使用了“非典型肺炎”这一名称。真正的非典型肺炎是支原体肺炎的旧称，其发生率占小儿肺炎的15％～20％。支原体肺炎全年均可发病，但以秋冬季多见。在大、中、小学校和某些集体单位可引起小流行。支原体肺炎病人和支原体携带者是本病的传染源，主要通过飞沫传播。儿童支原体肺炎有一定的流行规律，每3～4年流行一次，今年是我国支原体肺炎流行高峰年。

支原体肺炎有什么症状：肺炎支原体感染的潜伏期可达2～3周。潜伏期过后，多数病人表现为咽炎、鼻炎、气管炎和毛细支气管炎，出现发热、头痛、畏寒、咳嗽、全身不适、明显疲乏、食欲不振等症状。咳嗽初期为干咳，后转为顽固性剧烈咳嗽，无痰或伴有少量黏痰，特别是夜间咳嗽较为明显。婴幼儿表现为喘憋和呼吸困难，严重者可发生支原体肺炎。发生支原体肺炎的儿童占全部肺炎支原体感染者的3％～10％。

肺炎支原体感染的危害是什么：肺炎支原体感染除能引起呼吸道病变外,还能引起心肌炎、肝炎、关节炎、肾炎、脑膜炎、溶血性贫血、血小板减少性紫癜等呼吸系统以外的疾病。因此，必须予以重视。

如何诊断：家长要确认孩子是否得了支原体感染，医院对孩子的痰液进行肺炎支原体培养或取血检测血中肺炎支原体抗体、抗原等，才能得出正确诊断。 　　

治疗方案：儿童得了支原体肺炎应及早治疗，首选药物为红霉素、罗红霉素或阿奇霉素，早期应用效果更好。先锋霉素、青霉素和磺胺药一般无效。由于红霉素等抗生素有一定的副作用，所以，家长应该在医生指导下给孩子使用，不可自行用药。咳嗽剧烈者可以用易坦静、鲜竹沥等祛痰止咳药。在生病期间，家长要让孩子多休息，卧室内要保持空气新鲜。对支原体肺炎患儿来说，最佳的室温是18～20℃，同时保持60％的空气湿度，以防呼吸道分泌物变干而不易咳出。家长还要注意给孩子做一些营养丰富而又易于消化的食物，且宜少量多餐，鼓励孩子多饮水。由于支原体肺炎具有传染性，且容易复发，因此患病期间要注意隔离，治疗要彻底。 　　

怎样预防肺炎支原体感染：家长平时应多带孩子到户外活动，进行身体锻炼，改善呼吸功能，增强体质。还要教育孩子在咳嗽时用手帕或纸捂嘴，尽量减少飞沫向周围喷射；不随地吐痰，防止病菌污染空气而传染他人。易患呼吸道感染的孩子在寒冷季节或气候骤变外出时，要注意增添衣服，以防受寒感冒。

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