目的 研究儿童腺病毒肺炎合并塑型性支气管炎（PB）的临床特点及预后。方法 回顾性分析2018年1月至2022年12月确诊的11例腺病毒肺炎合并塑型性支气管炎患儿的临床资料及随访结果。结果 11例患儿，男7例、女4例，中位年龄6（1~7）岁，均有发热咳嗽，3例伴有喘息，6例有气促，7例有呼吸音减低。热程（7.55±3.59）天，热峰（39.95±0.79）℃。7例合并中毒性脑病，8例存在肝功能损害。所有患儿均有乳酸脱氢酶（LDH）、白细胞介素6（IL-6）、降钙素原（PCT）不同程度升高，C-反应蛋白（CRP）>30 mg/L者7例。胸部CT加三维重建提示以肺实变为主，肺不张6例，胸腔积液4例。6例给予了丙种球蛋白，9例接受了甲基泼尼松龙，5例予面罩给氧，1例予机械通气，后改为静脉-静脉体外膜肺氧合（V-V-ECMO）。所有病例均行支气管镜下塑型物取出，行1次支气管镜者7例，2次支气管镜者4例。1例死亡，余均好转出院。随访中1例出现反复咳喘，余预后良好。 结论 腺病毒肺炎合并PB者多表现为持续高热、气促、低氧、呼吸音减低，伴有CRP、PCT、LDH明显升高，影像学多存在肺不张、肺实变，易合并其他器官损伤，应给予积极抗炎、尽早行纤维支气管镜检查治疗，多数预后良好，少数可出现反复咳喘等不良预后。

Objective To study the clinical features and prognosis of adenovirus pneumonia complicated with plastic bronchitis in children. Methods The clinical data and follow-up results of 11 children with adenovirus pneumonia complicated with plastic bronchitis diagnosed in hospital from January 2018 to December 2022 were retrospectively analyzed. Results The median age of the 11 patients (7 boys and 4 girls) was 6.0 years old. All of them had fever and cough, 3 children were accompanied by wheezing, 6 had shortness of breath, and 7 had decreased breathing sounds. The mean duration of fever was (7.55±3.59) days, the mean peak of temperature was (39.95±0.79) ℃. There were 7 children with toxic encephalopathy and 8 with liver function impairment. The LDH, IL-6 and PCT levels were increased to different degrees in all patients, and CRP>30mg/L was found in 7 patients. Chest CT+3D reconstruction showed that lung consolidation was the main lesion, including atelectasis in 6 cases and pleural effusion in 4 cases. Six patients were administered with intravenous immunoglobulin, and 9 patients received methylprednisolone. Five patients received facial mask oxygen inhalation. One child received mechanical ventilation, and then changed to V-V-ECMO. All children underwent bronchoscopy and plastic body removal. Among them, 7 patients received bronchoscopy once and 4 received bronchoscopy twice. One child died and the others were discharged after improvement. During follow-up, 1 child had recurrent cough and wheezing, and the others had good prognosis. Conclusions Adenovirus pneumonia with plastic bronchitis is usually characterized by persistent high fever, shortness of breath, hypoxia, reduced breath sound, and significantly increased levels of CRP, PCT and LDH. Most of the imaging findings show atelectasis and lung consolidation, which are easy to combine with other organ injuries. Active anti-inflammatory therapy and bronchoscopy should be performed as soon as possible. Most of patients have a well prognosis, while a few may have poor prognosis such as recurrent cough and wheezing.