Objective To investigate the effect of tissue-type plasminogen activator (t-PA) on symptom improvement and blood oxygenation in children with plastic bronchitis plastic bronchitis (CB). Methods 60 CB children admitted in our hospital were randomly divided into group A (30 cases) and group B (30 cases). Both groups were operated by fiberoptic bronchoscopy to remove foreign bodies, besides, the group B was perfused with recombinant t-PA into blocked bronchi. The inflammatory indexes before and after the treatment [white blood cell (WBC), C reactive protein (CRP) and interleukin -6 (IL-6)] were compared, and the curative effects [effective rate of operation, blood oxygen saturation (SpO2) after a week, body temperature recovery time, hospitalization time and recurrence rates after treatment in the two groups were observed. Results The effective rate of operation and SpO2 level in the group B were all higher than those in the group A(P<0.05) after a week, the hospitalization time and body temperature recovery time in the group B were all shorter than those in the group A (P<0.05), after treatment, the WBC, CRP and IL-6 levels in the two groups were decreased, and the decrease in the group B was higher than that in the group A (P<0.05), after 6 months follow-up, the recurrence rate in the group B was lower than that in the group A (P<0.05). Conclusion Compared with single fiberoptic bronchoscopy surgery, conventional treatment combined with t-PA regimen which is more effective and favorable for the prognosis of disease, can effectively improve the status of hypoxia in children with CB.