这“三件套”慎用！
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<span style="outline: 0px;font-size: 16px;">近期，支原体肺炎来势汹汹</span>
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<span style="font-size: 16px;"><span style="outline: 0px;">台州</span><span style="letter-spacing: 0.544px;">光一家医院日门诊量就达七八十例</span></span>
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<span style="font-size: 16px;">与此同时</span>
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<span style="outline: 0px;color: rgb(0, 122, 170);font-size: 16px;"><strong style="outline: 0px;">“阿奇霉素+布洛芬</strong></span>
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<span style="outline: 0px;color: rgb(0, 122, 170);font-size: 16px;"><strong style="outline: 0px;">+愈酚甲麻那敏”</strong></span>
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<span style="outline: 0px;font-size: 16px;">被认为可治疗肺炎支原体感染的</span>
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<span style="outline: 0px;font-size: 16px;">用药“三件套”</span>
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<span style="outline: 0px;font-size: 16px;">最近在朋友圈里热传</span>
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<span style="font-size: 16px;"><span style="outline: 0px;">武汉儿童医院发布</span><span style="outline: 0px;letter-spacing: 0.034em;">专家提醒：</span></span>
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<span style="outline: 0px;color: rgb(171, 25, 66);font-size: 16px;"><strong style="outline: 0px;">自行用药有风险</strong></span>
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<span style="outline: 0px;color: rgb(171, 25, 66);font-size: 16px;"><strong style="outline: 0px;">特别是阿奇霉素等药物</strong></span>
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<span style="outline: 0px;color: rgb(171, 25, 66);font-size: 16px;"><strong style="outline: 0px;">需在医生或药师的指导下服用</strong></span>
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<span style="outline: 0px;color: rgb(255, 255, 255);font-size: 16px;"><strong style="outline: 0px;">医生忙到没时间上厕所</strong></span>
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<span style="font-size: 16px;"><span style="outline: 0px;color: rgb(255, 255, 255);"><strong style="outline: 0px;">一家医院每天门诊量七八十例</strong></span><strong style="outline: 0px;"></strong></span>
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<span style="color: rgb(55, 53, 53);letter-spacing: normal;text-align: start;text-indent: 28px;text-wrap: wrap;background-color: rgb(255, 255, 255);font-size: 16px;font-family: "Microsoft Yahei", "Helvetica Neue", Helvetica, Arial, sans-serif;">这段时间，随着全国各地医院儿科门诊的爆满和就诊患儿的增多，铺天盖地的科普文章和预防提醒在社交平台频频转发。</span>
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<span style="color: rgb(55, 53, 53);letter-spacing: normal;text-align: start;text-indent: 28px;text-wrap: wrap;background-color: rgb(255, 255, 255);font-size: 16px;font-family: "Microsoft Yahei", "Helvetica Neue", Helvetica, Arial, sans-serif;">支原体肺炎为什么今年来势汹汹？医院情况怎么样？这波感染还要持续多久……和它打了近5个月的交道，台州市立医院儿科主任医师王英姿“有话要说”。</span>
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<span style="font-size: 16px;">支原体是一种介于细菌和病毒之间、目前世界上已知能**生存的最小微生物；支原体肺炎就是由肺炎支原体引起的急性肺部感染性疾病，是我国5岁及以上儿童最主要的社区获得性肺炎。它广泛存在于全球范围内，约3至7年会发生一次地区性流行，没想到今年就“来了波大的”。</span>
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<span style="font-size: 16px;">早在7月份，记者就咨询过王英姿，那会儿支原体肺炎已经占据了儿科病房的“半壁江山”。粗略估计，儿科门诊量一天约300多人，其中支原体肺炎患者约占40人。<span style="color: rgb(171, 25, 66);"><strong>近三个月，支原体肺炎流行不仅势头未减，患者还在“噌噌”往上涨，门诊量最多时增加到400至500多人，其中支原体肺炎有70至80多人。</strong></span></span>
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<span style="font-size: 16px;">“医院共有7个儿科诊室，忙起来全开，许多医生上午8点开始坐诊，一直忙到下午才下班。”王英姿说，最近有位医生从上午一直坐到下午三四点，中间没喝水吃饭和上过厕所，因为患者源源不断。</span>
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<span style="font-size: 16px;">其次，支原体肺炎患者大部分是学龄期前后，由于上学的关系，有部分家长会选择晚上看急诊。“原先病人少的时候只有1位医生，现在我们增开了专家门诊，由3个医生一起分担急诊量，等忙完时间也不早了。”</span>
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<span style="outline: 0px;color: rgb(255, 255, 255);font-size: 16px;"><strong style="outline: 0px;">阿奇霉素是首选用药</strong></span>
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<span style="font-size: 16px;"><span style="outline: 0px;color: rgb(255, 255, 255);"><strong style="outline: 0px;">药店销量增加但供应充足</strong></span><strong style="outline: 0px;"></strong></span>
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<span style="font-size: 16px;">在治疗支原体肺炎的过程中，绕不开的就是阿奇霉素。</span>
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<span style="font-size: 16px;">据介绍，大家所熟悉的青霉素、头孢这类抗生素都是以细胞壁作为靶点，因此对支原体肺炎完全无效。目前，大环内酯类抗菌药物，如阿奇霉素、罗红霉素、克拉霉素，就是肺炎支原体感染的首选治疗药物。</span>
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<span style="font-size: 16px;">此前有市民发帖表示，支原体肺炎流行后，导致阿奇霉素卖“断货”，直呼“买不到”。就该药物供应情况，记者随机走访了我市多家药店，多位工作人员表示，<span style="color: rgb(171, 25, 66);"><strong>近期购买阿奇霉素药物的人数有所增加，但药物目前供应充足。</strong></span></span>
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<span style="font-size: 16px;">随后，记者在外卖平台上搜索发现，阿奇霉素干混悬剂、阿奇霉素软胶囊、阿奇霉素片等相关药物，周边药店均有售卖，市民无需担忧。</span>
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<span style="font-size: 16px;">此外，阿奇霉素走上“风口浪尖”，它的耐药问题近期也广受关注。</span>
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<span style="font-size: 16px;">王英姿在门诊中碰到不少。“阿奇霉素这么多年使用下来，确实存在耐药现象，但依然是支原体肺炎的主要用药，加上疫情以后市民加强防护流动性小，对支原体接触机会少，从而普遍对支原体免疫力低，治疗效果自然有所下降。”针对这个情况，她在碰到支原体感染病情严重，存在支原体免疫反应病人开方时还会适当使用激素帮助治疗。</span>
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<span style="outline: 0px;color: rgb(255, 255, 255);font-size: 16px;"><strong style="outline: 0px;">感染高峰预计持续到寒假后</strong></span>
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<span style="font-size: 16px;">采访中，王英姿提到了一件令人担忧的事：从上星期开始，支原体肺炎的重症患儿在逐渐增多，这意味着“仗”远没有结束。“专家预测，支原体肺炎的感染高峰将出现在11月，预计可能会持续到寒假过后，接下来的几个月还有的忙。”</span>
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<span style="font-size: 16px;">患者越来越多，医院如何应对？王英姿表示门诊会尽量安排医生坐诊，满足就诊需求。病床如果已经饱和，医院还会安排患者跨科室住院，合理调配资源，把方便留给患者。</span>
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<span style="font-size: 16px;">对于日常生活中的预防，市疾控中心日前发布了相关提醒——学生群体不要带病上课，身体不适时应立即向老师和家长报告，平时要保持良好的个人卫生习惯，咳嗽或打喷嚏时，遮掩口鼻，注意手卫生，避免用未清洁的手触摸口眼鼻。（此前报道→<span style="text-decoration: underline;"><a target="_blank" href="http://mp.weixin.qq.com/s?__biz=MzA4MTE0OTMxMg==&mid=2651763474&idx=1&sn=42e469c227296389c2515e76e695d721&chksm=84637ffdb314f6eb84ed6a2cc48d372dd1287755b0af59f62eda95dadbe76a51f8c995518e06&scene=21#wechat_redirect" textvalue="一家3口确诊！浙江部分班级紧急停课！台州疾控重要提醒" linktype="text" imgurl="" imgdata="null" data-itemshowtype="0" tab="innerlink" data-linktype="2">台州疾控重要提醒</a></span>）</span>
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<span style="font-size: 16px;">除了支原体肺炎，王英姿还提醒市民，接下来还要警惕流感和呼吸道合胞病毒感染。“秋冬季节原本就是呼吸道疾病的高发季节，且呼吸道疾病大多具有传染性，建议市民多长个‘心眼’，做好个人防护。”</span>
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<span style="color: rgb(255, 255, 255);background-color: rgb(255, 76, 65);font-size: 16px;"><strong>新闻＋</strong></span>
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<span style="outline: 0px;color: rgb(255, 255, 255);font-size: 16px;"><strong style="outline: 0px;">社交媒体“三件套”刷屏</strong></span>
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<span style="font-size: 16px;"><span style="outline: 0px;color: rgb(255, 255, 255);"><strong style="outline: 0px;">孩子一咳嗽妈妈就买“三件套”</strong></span><strong style="outline: 0px;"></strong></span>
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<span style="outline: 0px;font-size: 16px;">武汉市民赵女士有个4岁的女儿，10月24日，她发现女儿有些咳嗽，联想到朋友圈里最近热传的“支原体肺炎上岸教程”，里面写到咳嗽是“潜伏期”的典型症状，赵女士担心孩子正是这种情况，就按照“教程”和另一份肺炎支原体网红“三件套”，购买了阿奇霉素、布洛芬和愈酚甲麻那敏。</span>
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<span style="outline: 0px;font-size: 16px;">为弄清楚女儿的病情，10月25日，赵女士带着女儿到武汉儿童医院做进一步检查，结果显示，<strong style="outline: 0px;">女儿其实是病毒感染，只要遵医嘱对症处理，多加观察即可。</strong></span>
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<span style="outline: 0px;color: rgb(136, 136, 136);font-size: 16px;">社交媒体上，网友纷纷发布“支原体肺炎”相关体验。“阿奇霉素”成为关键词条之一。</span>
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<span style="font-size: 16px;"><strong style="outline: 0px;color: rgb(255, 255, 255);font-size: 16px;letter-spacing: 0.578px;">医生提醒：</strong></span>
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<span style="font-size: 16px;"><strong style="outline: 0px;color: rgb(255, 255, 255);font-size: 16px;letter-spacing: 0.578px;">用药需要遵医嘱</strong></span>
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<span style="outline: 0px;font-size: 16px;">“孩子这么小，不能按照网上的‘用药宝典’，自己给孩子用药。特别是阿奇霉素，属于抗菌类药物，是处方药，要遵医嘱用药。”武汉儿童医院医生提醒赵女士，即便孩子被确诊为肺炎支原体感染，按照网络教程吃药也不可取。</span>
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<span style="outline: 0px;font-size: 16px;">根据今年国家卫健委发布的《儿童肺炎支原体肺炎诊疗指南》，阿奇霉素、克拉霉素等大环内酯类抗生素仍是小儿支原体肺炎的首选用药。</span>
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<span style="outline: 0px;font-size: 16px;">尽管在朋友圈里被热捧，阿奇霉素也不能自行随意使用。武汉儿童医院药学部副主任药师刘茂昌介绍，经过医生判断，<span style="outline: 0px;color: rgb(0, 122, 170);"><strong style="outline: 0px;">孩子确需服用阿奇霉素来进行抗感染治疗，用药仍有很多需要注意的细节。</strong></span></span>
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<span style="outline: 0px;letter-spacing: 0.578px;font-size: 16px;">一般情况下，阿奇霉素有两种经典疗法。</span>
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<span style="outline: 0px;letter-spacing: 0.578px;font-size: 16px;">其中，3日疗法是按照10mg/kg的剂量连续服药3天，每日服药一次；</span>
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<span style="outline: 0px;letter-spacing: 0.578px;font-size: 16px;">5日疗法是连续服药5天，第1天的剂量为10mg/kg，第2—5天的剂量为5mg/kg，每日服药一次。</span>
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<span style="outline: 0px;letter-spacing: 0.578px;font-size: 16px;">医生会根据孩子的体重、病情来调整服药的剂量、方式。</span>
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<span style="outline: 0px;font-size: 16px;">有些孩子使用阿奇霉素后疗效不明显，或是用药后出现严重胃肠道反应，医生也会考虑改用替代性药物，或是选择其他治疗方案。<span style="font-size: 16px;outline: 0px;color: rgb(171, 25, 66);"><strong style="outline: 0px;">因此，不建议家长盲目照搬网络上的推荐，自行用药。</strong></span></span>
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<span style="color: rgb(136, 136, 136);font-size: 14px;letter-spacing: 0.544px;">来源：台州晚报综合健康中国、长江日报</span><br/>
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