目的研究小儿脓胸治疗策略。方法总结1999年至2009年收治的3万例肺部感染病例,其中胸腔积液611例,脓胸407例。慢性脓胸行纤维板剥脱术261例,同时行肺叶切除术45例。随机200例行血培养、胸水培养。结果 261例手术患儿全部治愈,无支气管胸膜瘘。血培养及胸水培养肺炎球菌占第一位,葡萄球菌占第二位,但阳性率不高。发病年龄1～3岁为高发期。结论婴幼儿是脓胸高发人群,细菌培养在病因学诊断上并不是最敏感的方法。正确有效的治疗程序是减少脓胸发生及治愈的关键。 Objective To study pediatric empyema treatment strategy. Methods Thirty thousand cases of pulmonary infection admitted from 1999 to 2009 were summarized, including 611 cases of pleural effusion and 407 cases of empyema. Chronic empyema line fibrex stripping in 261 cases, while 45 cases of lobectomy. Random 200 cases of blood culture, pleural effusion culture. Results All 261 cases of surgical treatment of children without bronchopleural fistula. Blood culture and pleural effusion pneumococcus accounted for the first place, Staphylococcus accounted for second place, but the positive rate is not high. Age of onset of 1 to 3 years of high incidence. Conclusion Infants and young children are high incidence of empyema, bacterial culture in etiology is not the most sensitive method of diagnosis. The correct and effective treatment is to reduce the incidence of empyema and cure the key.