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在儿科气管切除术后,气管A框架形和腹上塌
Rishi Suresh1, Helene Dabbous2, Swapnika Alahari3
1Department of Otolaryngology - Head & Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA.
Laryngoscope investigative otolaryngology
|February 16, 2024
概括
儿科气管切除术可以导致A框架形,在36%的儿童中,在断管切除后3年内. 上塌影响了近74%的儿童5年后的气管切除术,特别是那些在较年轻时被切除的儿童.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 呼吸系统医学 呼吸系统医学
- 外科手术的结果
背景情况:
- 气管切除术是儿童常见的手术,需要长时间的气道支.
- 获得的气道狭窄,包括A框架变形和胃上倒塌,是儿科气管切除术后已知的并发症.
- 这些特定的呼吸道并发症的长期结果和发病率需要进一步阐明.
研究的目的:
- 为了确定A-frame变形和腹上塌的发病率,在小儿科患者中进行气管切除术后.
- 为了确定风险因素和时间模式与这些后气管切除术气道并发症的发展相关.
主要方法:
- 追溯队列研究,包括2015年至2020年间接受气管切除术的儿科患者 (<18岁).
- 包括标准要求监测支气管镜检查至少6个月后的气管切除术.
- 经营报告进行了审查,以确定A框架形和腹上塌.
主要成果:
- 在175名儿童中,A框架形发生在18%的儿童中,估计5年发生率为32.8%.
- 在55%的患者中发生了顶塌,估计5年发病率为73.7%.
- 气管切除术时的年龄较大与崩的可能性较低有关 (OR:0.92),而高度复杂的儿童则经历了较早的A框架发育.
结论:
- 气管A框架形影响了儿童的很大一部分在3年后的decannulation.
- 上倒塌的患病率很高,在5岁时接近74%,在年轻患者中更为常见.
- 临床医生应该意识到这些获得的呼吸道阻塞,并相应地监测儿科气管切除术患者.
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