为提高对坏死性肺炎临床表现的认识和诊治成功率，收集自2007年8月~2012年7月入住本院经肺组织病理确诊为坏死性肺炎的9例患儿资料，通过分析临床表现、影像学资料、病理和微生物学检查结果，并结合治疗经过和转归，讨论儿童坏死性肺炎的诱因、早期诊断与相关治疗手段。9例患儿（男6例、女3例）年龄1~7岁（平均3.5岁），持续发热11~43 d（平均22 d）。4例接受机械通气治疗，5例病原学检查为阳性，8例计算机断层扫描（CT）提示肺内出现多发小空洞。9例患儿均存在肺实变伴胸腔积液，病理学诊断为大片肺坏死伴炎性浸润，进行外科手术介入治疗并存活，术后10个月CT提示肺结构恢复正常。结果表明，儿童坏死性肺炎常见病原菌为肺炎链球菌和肺炎支原体；胸部CT扫描结果需结合临床综合判断；坏死性肺炎患儿经积极抗感染及手术治疗预后良好。

In order to analysis the clinical characteristic of necrotizing pneunomia in children, a retrospective investigation of the clinical manifestations, radiological findings, pathology, microbiology, clinical courses and outcomes of 9 children (6 males, 3 females) with necrotizing pneumonia was performed. The age range was 1-7 years (average 3.5 years). The duration of fever was 11-43 d (average 22 d). Four cases received mechanical ventilation. There were 5 cases with microbiological identification, 2 cases with Streptococcus pneumoniae, 2 cases with Mycoplasma pneumoniae and 1 case with Pseudomonas aeruginosa. The chest CT scans showed pneumonic lobar consolidation and pleural effusion in 9 cases, and small cavities in the consolidation regions in 8 cases. All 9 patients received surgical intervention, 7 with wedge resection, 1 with segmentectomy, and 1 with lobectomy. All the specimens exhibited parenchymal necrosis and acute inflammatory infiltration. All 9 patients survived. Seven patients had full clinical resolution within 6 months, and 2 patients resolved in 10 months. Streptococcus pneumoniae and Mycoplasma pneumoniae were found to be the predominant pathogens in children with necrotizing pneumonia. The chest CT scan is crucial in the diagnosis. The prognosis is good after antibiotic and surgical therapy.