Abstract: 　Objective　To explore the clinical characteristics and diagnosis of children's aspiration pneumonia. Method The clinical data of aspiration pneumonia in 164 hospitalized children from January 1, 2013 to December 31, 2018 were retrospectively analyzed. Results　In 164 patients (103 boys and 61 girls) with the age at onset ranging from 29 days to 13 years, 124 patients (75.6%) were under 6 years old. Thirty-four children had underlying diseases and neurological abnormalities were the most common (27 cases). The history of inhalation was found in 141 (86.0%) children and drowning was the most common cause. There was no definite inhalation history in 23 children (14.0%), but all of them had neurological abnormalities or congenital upper airway/digestive tract abnormalities. The common clinical symptoms were cough, shortness of breath, fever and disturbance of consciousness. Only 79 cases (48.2%) had respiratory symptoms and lung rales simultaneously. Chest radiograph or chest CT examination in 160 cases indicated pneumonia, and 142 cases showed bilateral lung involvement, mainly middle and lower lung lobes. A total of 127 (77.4%) children were examined for pathogenic bacteria, and 64 strains were gram-negative bacteria and 24 strains were gram-positive bacteria. The common bacteria were Escherichia coli (17 strains), Streptococcus pneumoniae (17 strains) and Haemophilus influenza (9 strains). All patients treated by antibiotics and 142 recovered and 22 had poor prognosis. Conclusions　The clinical manifestations of aspiration pneumonia in children are complex, and the history of inhalation, inhalation risk assessment, and lung imaging are helpful for the diagnosis. Etiological examination is helpful for rational use of drugs.

Key words: child;　aspiration pneumonia;　clinical analysis;　diagnosis;　etiological examination