支原体肺炎病例分享的.pptVIP

病例分享 山西省儿童医院 张晓娟 2011-4-27 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 病例 患儿，女，1岁，主因咳嗽1月，发热3天入院。 现病史：患儿于1月前无明显诱因出现咳嗽，刺激性干咳，每次10余声，频繁，院外口服感冒药，消炎药体温最高39℃，伴咳嗽、干咳、气促、胸痛，入当地医院输“青霉素、头孢曲松、炎琥宁”等药物6天，无效，转入吕梁市人民医院输“青霉素、哌拉西林舒巴坦、地塞米松” 3天，无缓解，入我院。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 既往体健，无过敏史，预防接种按序。 入院查体：T 38.9℃ HR 134次/分 R 35次/分，神清，反应可，鼻扇阴性，三凹征阴性，口周无发绀，咽充血，右肺呼吸音粗，左肺下呼吸音减低。心腹未见异常。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 4-21 胸片：左肺炎，左侧胸腔积液。 胸部彩超：左侧少量胸腔积液。 WBC:13.7×10^9/L,N%:72%, L%:26.9%, 4-21支原体抗体:阴性。 4-23PPD:阴性。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 入院诊断：支原体肺炎 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 治疗 4-25 阿奇霉素10mg/kg/日 iv qd×7d 4-25甲强龙 1mg/kg/次 iv bid×2d 次日热退 4-27 改为qd×1d Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 辅助检查 4-25胸部CT示：左肺炎性改变，左肺下叶实变。左侧胸腔积液。左侧叶间胸膜增厚 4-26WBC:12.6×10^9/L,N%:70%,L%:29.9%, 4-26 CRP77mg/L 血沉：65mm/h ： 4-26 支原体抗体：1:160 4-28胸部彩超：左侧少量胸腔积液。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 4-30复查胸片示：左肺炎，左侧胸腔积液。 5-2WBC:6.53×10^9/L， N%:45.4%，L%:62.9%。 5-2血沉：65mm/h,CRP:39mg/L。 5-2血培养示：无菌生长。 5-2PP