目的：探讨甲型H1N1/H3N2 感染合并塑型性支气管炎（PB）的病理特征及诊治方法。方法：报告3 例我院收治的甲型

H1N1/H3N2 感染合并PB儿童的病例资料，总结布地奈德混悬液雾化吸入联合纤支镜灌洗的治疗经验，并结合文献内容对该少见

病种进行分析。结果：3 例患儿中有2 例甲型H1N1、1 例甲型H3N2 感染合并PB，其中2 例有基础疾病，分别为支气管哮喘与原发

性肾病综合征。3 例患儿均诊断为重症肺炎、呼吸衰竭、肺不张，其中2 例伴有纵膈气肿、皮下气肿。经纤支镜检查均取出树枝状

异物，病理检查均为纤维素性渗出，伴有中性粒细胞、嗜酸性粒细胞及淋巴细胞浸润，确诊为PB。3 例患儿经过辅助呼吸、呼吸道

管理、抗感染等对症支持治疗，并采用布地奈德混悬液雾化吸入联合纤支镜灌洗后均痊愈出院。结论：PB是甲型流感的合并症之

一，病情危重。临床上一旦考虑该病，应在布地奈德混悬液雾化治疗基础上尽快行纤支镜检查，以明确诊断并及时治疗。

OBJECTIVE：To analyze the pathological characteristics and therapy method for influenza A（H1N1/H3N2）infection

complicated with plastic bronchitis （PB）. METHODS：Clinical information of 3 children with influenza A（H1N1/

H3N2）infection complicated with PB were reported to summarize the experience of aerosol inhalation of Budesonide suspension

combined with fiber bronchoscope lavage. Based on literatures，this rare disease were analyzed. RESULTS：Among 3 children，

2 children suffered from influenza A H1N1 infection and one child influenza A H3N2 infection complicated with PB；2 of

them got basic disease，i.e. bronchial asthma and primary renal syndrome. 3 children were diagnosed as severe pneumonia，respiratory

failure and pulmonary atelectasis；2 of them suffered from mediastinal emphesema and subcutaneous emphysema. The

branchlike foreign bodies，removed by fiber bronchoscope，were fibrin complicated with neutrophile granulocyte，eosinophile

granulocyte and leukomonocyte infiltration by pathological examinations. It was diagnosed as PB. 3 children received symptomatic

support treatment as assisted respiration，respiratory tract management and anti-infective treatment，and aerosol inhalation

of Budesonide suspension combined with fiber bronchoscope lavage. And then they were cured and discharged from the hospital.

CONCLUSIONS：PB is one complication of influenza A pneumonia and severe. Fiber bronchoscope must be carried out as

soon as possible based on aerosol inhalation of Budesonide suspension once PB is suspected，so as to diagnose early and treat

promptly.