小儿危重呼吸道阻塞的临床诊断和治疗  

Diagnosis and treatment of serious pediatric airway obstruction

作　　者：王双乐[1] 杨楚[1] 李创伟[1] 林炘[1] 杨冬涛[1] 陈恩河[1] 

机构地区：[1]广东省汕头市中心医院耳鼻咽喉头颈外科,515031

出　　处：《中华耳鼻咽喉头颈外科杂志》2006年第4期251-254,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的探讨小儿危重呼吸道阻塞的临床诊断及治疗方案。方法1995年1月至2005年1月汕头市中心医院耳鼻咽喉头颈外科收治73例小儿危重呼吸道阻塞,采用快速诊断和及时治疗的临床处理方法,分析应用该方法的效果。结果73例危重患者中炎症性疾病28例,占38.4%;异物33例,占45.2%,其他还有喉乳头状瘤8例,喉气管支气管痉挛3例,咽部畸胎瘤1例。采用气管插管和气管切开分别为39例次和27例次,占53.4%和37.0%,只采用内科治疗9例。72例患者均于12 h内确诊并解除重度呼吸道阻塞,1例未治自动出院。发生严重并发症者23例,发生率为31.5%;手术并发症3例,发生率为4.1%。死亡4例,治愈68例,治愈率为93.2%。结论小儿危重呼吸道阻塞的病因复杂,病情凶险,快速诊断、及时解除呼吸道阻塞和采取有效的病因治疗方案,有利于提高治疗效果。Objective To investigate the diagnosis and treatment of serious pediatric airway obstruction. Methods Seventy three pediatric cases with serious airway obstruction, admitted to Shantou hospital from 1995 to 2005, were analyzed retrospectively. Results Among the 73 cases, 28 cases （38.4%） with inflammatory disease and 33 cases（45. 2%） with foreign body. In addition,8 cases of laryngeal papilloma,3 cases of laryngotracheobrenchial spasm and 1 case of pharyngeal dysembryoma were also included in this study. The patients who had endotracheal intubatiou or tracheotomy were 39 cases （53.4%） and 27 cases（36. 9% ） respectively. Ten cases received non-surgery treatment. Seventy two cases diagnosis was confirmed and the related serious airway obstruction condition got stable within 12 hours. While serious complications occurred in 23 cases（31.5% ） and operative complications occurred in 3 cases （4. 1% ）. Four cases（ 5.5% ） died and 68 cases（93.2% ） were cured. One case refused to be treated. Conclusions The condition of serious pediatric airway obstruction patients is usually critical, the related causes could be complicated, quick diagnosis and timely removal of the obstruction factors are imperative.

关 键 词：气管疾病 支气管疾病 儿童 

分 类 号：R720.597[医药卫生—急诊医学]