目的探讨阿奇霉素联合丙种球蛋白治疗小儿难治性支原体肺炎的临床疗效,评估患儿预后改善状况。方法选择武警浙江总队嘉兴医院2014年1月-2015年12月收治的难治性支原体肺炎患儿98例,随机分为对照组(49例)和治疗组(49例),对照组患儿给予阿奇霉素序贯治疗。治疗组阿奇霉素联合丙种球蛋白治疗。评估两组患儿临床疗效、主要临床症状(或体征)消失或恢复时间。结果治疗组患儿总有效率为85.71%,对照组为71.43%,两组比较,差异有统计学意义(P<0.05);两组不良反应比较,差异无统计学意义(P>0.05),治疗组患儿咳嗽消失时间、体温恢复正常时间、肺部啰音消失时间、肺部X线阴影吸收时间和住院时间分别为(5.65±1.82)d、(4.32±1.03)d、(6.29±1.14)d、(6.45±1.92)d和(8.14±1.70)d,对照组分别为(8.21±2.04)d、(5.79±1.17)d、(7.67±1.25)d、(8.03±2.18)d和(9.92±1.86)d,两组比较,差异有统计学意义(P<0.05)。结论阿奇霉素联合丙种球蛋白治疗小儿难治性支原体肺炎具有较好的临床疗效,能够显著缩短患儿症状、体征改善或消失时间,改善患儿预后,且具有较高的安全性。 Objective To investigate the clinical efficacy of azithromycin combined with gamma globulin in the treatment of refractory mycoplasma pneumonia in children and to evaluate the prognosis of children. Methods A total of 98 children with refractory mycoplasma pneumonia who were treated in Jiaxing Hospital of Zhejiang Province from January 2014 to December 2015 were randomly divided into control group (49 cases) and treatment group (49 cases), control group Azithromycin sequential treatment. Treatment group azithromycin combined with gamma globulin treatment. To evaluate the clinical efficacy of two groups of children, the main clinical symptoms (or signs) disappeared or recovery time. Results The total effective rate was 85.71% in the treatment group and 71.43% in the control group. There was significant difference between the two groups (P <0.05). There was no significant difference in adverse reactions between the two groups (P> 0.05) The cough disappearance time, body temperature returned to normal time, pulmonary rales disappearance time, pulmonary X-ray shadow absorption time and hospital stay in the treatment group were (5.65 ± 1.82) d, (4.32 ± 1.03) d, (6.29 ± 1.14 ), d (6.45 ± 1.92) d and (8.14 ± 1.70) d in the control group were (8.21 ± 2.04) d, (5.79 ± 1.17) d, (7.67 ± 1.25) d and 9.92 ± 1.86) d, the difference between the two groups was statistically significant (P <0.05). Conclusion Azithromycin combined with gamma globulin in children with refractory mycoplasma pneumonia has a good clinical efficacy, can significantly reduce the symptoms of children, signs of improvement or disappearance of time to improve the prognosis of children with high safety.