目的 分析难治性肺炎患儿的CT 影像学表现特点。方法 选取2014年7月 至2016年7月我院收治的支原体肺炎患儿 50例为研究对象，将难治性肺炎患儿纳入 难治组，普通肺炎患儿纳入普通组，均行 CT检查，比较两组性别、年龄、热程等一 般资料，分析肺炎患儿CT影像特征，比较 两组CT影像特点。结果 难治组性别、肺 部啰音发生率与普通组比较无显著差异 (P>0.05)，而其年龄(9.56±1.32)岁、热 程(11.20±1.57)d大于普通组(P<0.05)； 50例肺炎患儿中，单侧肺叶病变37例，双 侧病变13例，单叶段病变22例，双叶段病 变28例，单侧肺叶病变率74％高于双侧 26.0％，双叶段病变率56.0％高于单叶段 病变44.0％；病变主要表现为大片实变 影、斑点状或斑片状实变影、胸腔积液、 散在斑点及斑片状影，累及左肺与右肺肺 上叶、中叶、下叶；难治组少量胸腔积 液45.0％、胸膜肥厚60.0％及肺外改变 70.0％显著多于普通组，难治组树芽征发 生率10.0％较普通组43.3％少(P<0.05)。 结论 难治性肺炎患儿发热时间长、年龄 大，CT影像主要表现为肺段实变，伴少量 胸腔积液及胸膜肥厚增多，树芽征较普通 肺炎患儿减少，可作为临床诊断依据。

Objective To analyze the imaging findings of CT in children with refractory pneumonia. Methods From July 2014 to July 2016, 50children with mycoplasma pneumonia in our hospital were selected as study subjects. Children with refractory pneumonia were included into the refractory group while children withcommonpneumonia were included into the common group. All subjects underwent CT, and the general data were compared between the two groups. The imaging findings of CT were analyzed and compared between the two groups. Results The gender and incidence of pulmonary ralesshowed no significant differences between the two groups (P>0.05) while age and duration of fever of the refractory group were larger and longer than those of the common group (P<0.05). Among the 50 children with pneumonia, there were 37 cases with unilateral lung lobe lesions, 13 cases with bilateral lesions, 22 cases with single segment lesions and 28 cases with double segments lesions. The incidence rate of unilateral lung lobe lesions(74.0%) was higher than that of bilateral ones (26.0%), and the incidence rate of double segments lesions (56.0%) was higher than the single segment lesions (44.0%). The lesions mainly manifested as large-are solid shadow, spotlike or patchy solid shadow, pleural effusion, scattered spots and patchy shadow, involving the left lung and upper, middle and lower lobes of right lung. The pleural effusion, pleural thickening and extrapulmonary changes in the refractory groupwere significantly more than those in the common group, and the incidence of tree-in-bud signs in the refractory group was lower than that in the common group(P<0.05). Conclusion The duration of fever in children with refractory pneumonia is long and the age of children is relatively higher. The main findings of CT include pulmonary segment consolidation, with a small amount of pleural effusion and pleural thickening. The tree-in-bud signs in children with refractory pneumonia are fewer than in children with common pneumonia, which can be used as the basis for clinical diagnosis.