摘要
目的分析婴幼儿声门下狭窄(SGS)合并喉裂的诊断与治疗,为复杂气道疾病的处理提供经验。方法回顾分析2016年4月~2020年7月我科收治的12例SGS合并喉裂患儿的临床资料。SGS程度:Ⅱ度3例、Ⅲ度8例、Ⅲ~Ⅳ度1例;合并喉裂类型:Ⅰ型10例、Ⅱ型1例、Ⅲa型1例。根据手术方式不同,将患儿分为4组:第1组3例,行单纯内镜下喉裂修补术;第2组7例,行内镜下喉裂修补术+(一期或分期)内镜下SGS球囊扩张喉成型术;第3组1例,行颈前进路开放式喉裂修补+甲状软骨移植喉气管成型术;第4组1例,仅行气管切开术。结果第1组术后均拔管,平均拔管时间为5 d;第2组术后均拔管,平均拔管时间为10 d;第3组术后第14天拔管失败,之后再次行气管切开术。术后随访3~41个月,平均29个月,83.3%(10/12)的患儿在治疗后得到并维持稳定的气道。结论SGS与喉裂合并存在的病例并不少见,完善的评估是避免漏诊、误诊的关键。手术修补喉裂是治疗SGS的基础。根据患儿具体情况制订个性化的治疗方案是提高预后的重要方面。
Objective To analyze the management of subglottic stenosis(SGS)combined with laryngeal cleft laryngeal clef in infants.Methods Data of 12 patients of SGS combined with laryngeal cleft accepted from February 2016 to July 2020 were analyzed retrospectively.Five patients presented with typeⅠlaryngeal clef,one with typeⅡlaryngeal clef and five patients were diagnosed with gradeⅢSGS,and one was diagnosed with gradeⅡSGS.Three patients underwent endoscopic laryngeal clef repair alone,and two patients underwent endoscopic laryngeal clef repair for their laryngeal clef and endoscopic balloon dilation for their SGS simultaneously.One patient had non-surgical therapy only.Results At the latest follow-up,all cases that had undergone surgical treatment had a complete cleft closure,and two of them were decannulated.Conclusions The coincidence of laryngeal clef and congenital SGS is not unusual.A comprehensive evaluation,especially endoscopic assessment is fundamental in order not to miss an underlying diagnosis.Surgical closure of the cleft lays a foundation for success of further treatment of congenital SGS.
作者
谭乐恬
陈超
李琪
许政敏
TAN Letian;CHEN Chao;LI Qi;XU Zhengmin(Department of Otorhinolaryngology,Children’s Hospital of Fudan University,Shanghai 201102,China)
出处
《中国眼耳鼻喉科杂志》
2021年第2期99-102,105,共5页
Chinese Journal of Ophthalmology and Otorhinolaryngology
关键词
声门下狭窄
喉裂
婴幼儿
Subglottic stenosis
Laryngeal cleft
Infants
