在气管切除术的儿科患者中, subglottic 狭窄和内内管管道输入之间存在关联
C Percul1, L Lerendegui1, P Lobos1
1Pediatric Surgery and Urology Department. Hospital Italiano de Buenos Aires. Buenos Aires (Argentina).
概括
长时间的输管治疗在儿童中增加了小结节下狭窄的风险. 早期的气管切除术可以预防儿童患者的气道损伤和狭窄,特别是六个月以下的儿童.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 临界护理医学 临界护理医学
- 儿科手术 儿科手术
背景情况:
- 输入管的持续时间是 subglottic 狭窄的主要危险因素.
- 气管切除术通常建议成年人在输管后10-15天后进行.
- 在儿童患者中进行气管切除术以预防狭窄症的最佳时间需要进一步调查.
研究的目的:
- 在儿科患者中分析输管时间和子喉狭窄症之间的关联.
- 为了确定气管切除术的最佳时间,以减少狭窄的发生率.
- 为了评估在被直管的儿童中发展狭窄的危险因素.
主要方法:
- 从2014年至2019年,对 2014年至2019年的气管切除术儿科患者进行了回顾性研究.
- 气管切除术时内镜检测结果的分析.
- 纳入标准侧重于新生儿和以前输管过的儿童.
主要成果:
- 189名患者进行了气管切除术;72人符合纳入标准.
- 下狭窄的总体发病率为21%.
- 狭窄症患者的平均输管时间 (30天) 与没有狭窄症患者的平均输管时间 (19天) 相比显着更长.
- 狭窄症的发生率随着输管时间的增加而增加,在一个月后达到20%.
- 6个月以下的婴儿对长时间输管有更大的耐受性,狭窄的中位时间为56天,较大儿童的时间为24天.
结论:
- 儿科患者长时间的输管治疗需要采取预防措施,防止喉外损伤.
- 建议在长期输管治疗的儿科患者早期考虑气管切除术.
- 年龄是对输管时间耐受性的重要因素,较年轻的婴儿需要更密切的监测.
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