ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 >

2026 , Vol. 7 >Issue 1: 83 - 85

DOI: https://doi.org/10.3761/j.issn.2096-7446.2026.01.013

重症护理研究

儿童重症支原体肺炎并发多种肺内并发症的早期识别及护理

  • 沈倩倩 ,
  • 章毅 ,
  • 方杭萍 ,
  • 李美 ,
  • 郑迎 ,
  • 陈朔晖
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  • 1.浙江大学医学院附属儿童医院/儿童少年健康与疾病国家临床医学研究中心消化内科 杭州市 310052
    2.浙江大学医学院附属儿童医院/儿童少年健康与疾病国家临床医学研究中心神经内科 杭州市 310052
    3.浙江大学医学院附属儿童医院/儿童少年健康与疾病国家临床医学研究中心呼吸内科 杭州市 310052
    4.浙江大学医学院附属儿童医院/儿童少年健康与疾病国家临床医学研究中心耳鼻咽喉科 杭州市 310052
    5.浙江大学医学院附属儿童医院/儿童少年健康与疾病国家临床医学研究中心院感管理科 杭州市 310052
沈倩倩：女，硕士，主管护师，E-mail：Akeano@zuaa.zju.edu.cn
*陈朔晖，E-mail：chcsh2@zju.edu.cn

收稿日期: 2025-03-19

  网络出版日期: 2026-01-06

基金资助

浙江省医药卫生科技计划项目(2023RC190)

收起

Early identification and nursing of multiple intrapulmonary complications in a child with severe mycoplasma pneumonia

  • SHEN Qianqian ,
  • ZHANG Yi ,
  • FANG Hangping ,
  • LI Mei ,
  • ZHENG Ying ,
  • CHEN Shuohui
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  • 1. Department of Gastroenterology， Children’s Hospital，National Clinical Research Center for Children and Adolescent’s Health And Diseases， Hangzhou 310052， China
    2. Department of Neurology， Children’s Hospital，National Clinical Research Center for Children and Adolescent’s Health And Diseases， Hangzhou 310052， China
    3. Department of Respiratory， Children’s Hospital，National Clinical Research Center for Children and Adolescent’s Health And Diseases， Hangzhou 310052， China
    4. Department of Otolaryngology， Children’s Hospital，National Clinical Research Center for Children and Adolescent’s Health And Diseases， Hangzhou 310052， China
    5. Department of Hospital-acquired Infection Control， Children’s Hospital，National Clinical Research Center for Children and Adolescent’s Health And Diseases， Hangzhou 310052， China

Received date: 2025-03-19

  Online published: 2026-01-06

Supported by

Zhejiang Provincial Medical and Health Science and Technology Plan Project(2023RC190)

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摘要

总结1例重症支原体肺炎并发塑型性支气管炎、坏死性肺炎伴液气胸及肺栓塞患儿的护理体会。针对多并发症交织、疾病进展迅猛等问题，依托症状-影像-检验动态预警，实施阶梯式干预：支气管镜灌洗清除塑型物、胸腔闭式引流精细调控、D-二聚体导向抗凝。经36 d的救治，患儿康复出院。随访8个月，患儿影像学恢复良好。

关键词： 肺炎支原体; 肺炎; 肺栓塞; 儿童; 危重病护理

本文引用格式

沈倩倩 , 章毅 , 方杭萍 , 李美 , 郑迎 , 陈朔晖 . 儿童重症支原体肺炎并发多种肺内并发症的早期识别及护理[J]. 中华急危重症护理杂志, 2026 , 7(1) : 83 -85 . DOI: 10.3761/j.issn.2096-7446.2026.01.013

Abstract

To summarize the nursing experience for a child with severe mycoplasma pneumonia complicated by plastic bronchitis and necrotizing pneumonia with hydropneumothorax and pulmonary embolism. In response to the characteristics of multiple intertwined complications and rapid progression，we implemented stepwise interventions based on dynamic "symptom-imaging-laboratory" triple monitoring，including bronchoscopic lavage to remove plastic casts，meticulous regulation of closed thoracic drainage，D-dimer-guided anticoagulation. After 36 days of treatment，the child recovered and was discharged. After 8 months of follow-up，imaging of the child showed good recovery.

Key words： Mycoplasma Pneumonia; Pneumonia; Pulmonary Embolism; Child; Critical Care Nursing

参考文献

[1] 国家卫生健康委员会, 赵顺英, 钱素云, 等. 儿童肺炎支原体肺炎诊疗指南(2023年版)[J]. 国际流行病学传染病学杂志, 2023, 50(2):79-85.
  National Health Commission of the People’s Republic of China, Zhao SY, Qian SY, et al. Guidelines for the diagnosis and treatment of Mycoplasma pneumoniae pneumonia in chil-dren(2023 edition)[J]. Int J Epidemiol Infect Dis, 2023, 50(2):79-85.
[2] Ai L, Liu BZ, Fang L, et al. Comparison of Mycoplasma pneu-moniae infection in children admitted with community acqui-red pneumonia before and during the COVID-19 pandemic:a retrospective study at a tertiary hospital of southwest China[J]. Eur J Clin Microbiol Infect Dis, 2024, 43(6):1213-1220.
[3] Huang F, Gu WJ, Diwu JF, et al. Etiology and clinical features of infection-associated plastic bronchitis in children[J]. BMC Infect Dis, 2023, 23(1):588.
[4] 杨海明, 吴磊, 张磊, 等. 中国儿童肺炎支原体肺炎支气管镜围手术期管理专家共识[J]. 中国实用儿科杂志, 2024, 39(12):881-886+893.
  Yang HM, Wu L, Zhang L, et al. Expert consensus on the perioperative management of bronchoscopy for Mycoplasma pneu-moniae pneumonia in children in China[J]. Chin J Pract Pe-diatr, 2024, 39(12):881-886+893.
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