红霉素联合阿奇霉素序贯疗法与单用阿奇霉素治疗小儿支原体肺炎的[摘要]目的对比小儿支原体肺炎采用红霉素联合阿奇霉素的序贯疗法与单独使用阿奇霉素治疗的临床效果以及安全性。方法将2013年4月～2014年4月航空总医院儿科确诊的支原体肺炎患儿90例根据数字表法随机分为对照组和观察组，每组45例。所有患儿入院后卧床休息，进行常规对症治疗和护理干预。对照组患儿采用单纯阿奇霉素序贯疗法，阿奇霉素连续静脉滴注4d，之后阿奇霉素干混悬剂连续口服3d，停用4d后再重复进行2～3个疗程。观察组患儿采用红霉素联合阿奇霉素的序贯疗法，先口服环酯红霉素干混悬剂4～6d，之后阿奇霉素干混悬剂连续口服3d，停用4d后再重复进行2～3个疗程。对比两组临床效果、两组患儿退热时间、咳嗽消失时间、肺部湿??音消失时间、胸片阴影消失时间、住院时间以及不良反应发生率。结果观察组临床有总效率比对照组明显提高（P<0.05）；观察组患儿退热时间、咳嗽消失时间、肺部湿??音消失时间、胸片阴影消失时间以及住院时间均比对照组明显缩短（P<0.05）；观察组患儿发生恶心呕吐、腹痛腹泻、静脉炎、皮疹、肝功能异常等不良反应的情况比对照组明显降低（P<0.05）。结论红霉素联合阿奇霉素的序贯疗法，能明显改善小儿支原体肺炎的临床症状体征，缩短治疗时间，安全性高，能充分发挥红霉素和阿奇霉素的协同治疗作用，效果明显优于单纯阿奇霉素序贯疗法，可在临床推广应用。[关键词]红霉素；阿奇霉素；序贯疗法；小儿；支原体肺炎；有效；不良反应[]R563.1[文献标识码]A[]1673-7210（2016）06（c）-0173-04[Abstract]ObjectiveTocomparetheclinicalefficacyandsafetyoferythromycincombinedwithAzithromycinSequentialtherapyandAzithromycinintreatmentofmycoplasmapneumoniainchildren.MethodsFromApril2013toApril2014，90childrenwithmycoplasmapneumoniainAviationGeneralHospitalwererandomlydividedintothecontrolgroupandtheobservationgroupaccordingtothedigitaltablemethod，45casesineachgroup.Allthechildrenstayedinbedandrestedinbed，andweregiventheroutinesymptomatictreatmentandnursingintervention.ThecontrolgroupwastreatedwithAzithromycinSequentialtherapy，Azithromycincontinuousintravenousdripfor4days，thenAzithromycindrysuspensionwasoralfor3days，after4daysdiscontinuation，repeated2-3coursesoftreatment.Theobservationgroupwastreatedwitherythromycin，AzithromycinSequentialtherapy，Erythromycindrysuspensionoralfor3daysatfirst，thenAzithromycindrysuspensionoralfor3days，after4daysdiscontinuation，repeated2-3coursesoftreatment.Theclinicaleffect，thefeverclearancetime，thedisappearancetimeofcough，pulmonaryralesandchestX-rayshadow，hospitalizationtimeandincidenceofadversereactionswerecomparedbetweenthetwogroups.ResultsThetotaleffectiverateintheobservationgroupwassignificantlyhigherthanthatinthecontrolgroup（P<0.05）；defervescencetime，coughdisappearedtimeandlungwetraleslosttime，chestX-rayshadowdisappeartimeandhospitalizationtimeintheobservationgroupwassignificantlyshorterthanthoseinthecontrolgroup（P<0.05）；Nauseaandvomiting，abdominalpain，diarrhea，phlebitis，skinrash，liverdysfunctionandotheradversereactionsintheobservationgroupwassignificantlylowerthanthoseinthecontrolgroup（P<0.05）.ConclusionThesequentialtherapyoferythromycincombinedwithazithromycincanimprovetheclinicalsymptomsandsigns，shortenthetreatmenttimeofmycoplasmapneumoniaepneumoniainchildren，andisofhighsecurity；itcangivefullplaytotheeffectoferythromycinandazithromycininthetreatment，itseffectisbetterthansimpleAzithromycinSequentialtherapy，whichcanbeusedinclinicalapplication.[Keywords]Erythromycin；Azithromycin；Sequentialtherapy；Children；Mycoplasmapneumonia；Effective；A...