目的 探讨在儿童塑型性支气管炎(CB)治疗中组织型纤溶酶原激活剂(t-PA)对症状的改善情况及血氧状态的影响。 方法 采用随机数表法将60例儿童CB患者分为A、B 2组，每组各30例。2组均行纤支镜手术，B组在此基础上加用重 组t-PA。比较治疗前后炎症指标水平[白细胞(WBC)、C反应蛋白(CRP)、白介素-6(IL-6)]，观察治疗后2组的疗效 [手术有效率、1周后血氧饱和度(SpO2)、体温恢复正常时间]、住院时间及复发率的差异。结果 ①B组的手术有效 率及1周后SpO2水平均高于A组(P<0.05)，住院时间、体温恢复正常时间则短于A组(P<0.05)；②2组WBC、CRP、IL-6 指标水平均较治疗前降低，B组降幅大于A组(P<0.05)；③B组随访6个月复发率比A组低(P<0.05)。结论 较单用纤支 镜手术，常规治疗联合t-PA方案治疗儿童CB的疗效更显著，能有效改善患儿缺氧状况，于其病情转归有利。

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.