儿科LTR后的复发性狭窄症:促成因素和临床影响
Daniel Blumenthal1,2, James A Leonard1,2, Hengameh Behzadpour1
1Department of Pediatric Otolaryngology, Children's National Hospital, Washington, USA.
概括
在为儿科亚囊狭窄症 (SGS) 进行喉内重建 (LTR) 后长时间使用胃上支架,会增加复发性狭窄症的风险. 将支架持续时间限制在4周以下对于儿童呼吸道手术的更好的结果至关重要.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 呼吸道外科手术 呼吸道外科手术
- 儿科重症监护 儿科重症监护
背景情况:
- 喉外重建 (LTR) 是对儿科亚结节狭窄症 (SGS) 的一个关键干预措施.
- 在LTR之后,术后狭窄仍然是一个重大挑战.
- 识别导致持续性狭窄的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 评估儿科患者LTR后复发性狭窄症的临床影响.
- 为了确定与术后狭窄症发展相关的危险因素.
主要方法:
- 在2008年至2021年期间接受开放LTR的181名儿科患者的回顾性审查.
- 统计分析包括费舍尔的确切,曼-惠特尼,卡普兰-梅尔,日志等级,考克斯的比例危险回归和多变量后勤回归.
- 重复性狭窄症被定义为新的或恶化的狭窄症,尽管最初的LTR.
主要成果:
- 术后狭窄症患者的脱率显著降低,气管切除术和修订LTR的比率更高,脱时间延长.
- 第四级SGS和更长的胃上支架持续时间与反复性狭窄症的风险增加有关.
- 超过4周的支架持续时间是耐火性狭窄症的重要独立风险因素,而插入移植显示出保护作用.
结论:
- 在LTR后4周以上保持上胃支架与术后狭窄症的风险增加有关.
- 较短的支架持续时间和插入移植的使用可能会减轻在LTR后发展强迫性狭窄的风险.
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