标准化心胸外科手术后儿童声不运动的管理
Lacey Nelson1, Michael A Belsky1, Kara D Meister2,3
1Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California.
JAMA otolaryngology-- head & neck surgery
|February 26, 2026
概括
在心胸外科手术后,儿科单侧声不运动 (UVFI) 是常见的. 与保守治疗相比,注射喉膜整形 (IL) 改善了口服饮食通过排泄的进展,但结果可能会受到患者选择的影响.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 儿科心胸外科 儿科心胸外科
- 语音和语言病理学 语言病理学
背景情况:
- 单侧声不运动 (UVFI) 是小儿心胸外科手术后的常见并发症.
- 目前缺乏对儿科UVFI的治疗指南,并且有关注射喉膜整形术 (IL) 的现有文献不一致.
研究的目的:
- 建立一个标准化,多学科的协议,用于管理儿科UVFI心胸外科后手术.
- 分析治疗IL的儿科患者的康复模式和结果,与保守的方法对比.
主要方法:
- 在第三级护理中心进行前性队列研究.
- 包括接受大动脉心胸手术的婴儿 (≤1岁).
- 排除标准:早产,手术前的消化不良,临床衰退,或最初入院之外的IL.
主要成果:
- 包括128名患者;其中45名 (35.1%) 患有UVFI.
- 17名患者接受了IL,28人接受了保守的管理.
- 100%的IL患者通过口服饮食获得了通过排放的进展,而非IL患者的这一比例为64.3%.
- 在IL患者中,鼻胃输液管切除的中位时间较短 (-28天).
结论:
- 针对儿科UVFI管理的标准化临床途径可以改善结果评估.
- 与保守治疗相比,IL在手术后的立即阶段表现出更高的口服饮食进步率.
- 观察到的结果差异可能与患者的基线特征相混,需要谨慎地解释治疗疗效.
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