新生儿上呼吸道梗阻54例病因分析  

Etiology analysis of upper airway obstruction in 54 newborn infants

作　　者：王晓雪[1] 富建华[1] 薛辛东[1] 

机构地区：[1]中国医科大学附属盛京医院儿科,沈阳110004

出　　处：《中华实用儿科临床杂志》2013年第18期1398-1401,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的 探讨新生儿上呼吸道梗阻（UAO）的病因,以期早期诊断、治疗,改善预后.方法 回顾性分析2005年1月至2011年12月中国医科大学附属盛京医院新生儿科住院的54例UAO患儿的临床资料.全部病例（53例喉部,1例鼻咽部）行CT平扫＋三维重建检查,30例行直接喉镜检查,5例行电子鼻咽喉镜,8例术后行病理检查,54例行血清总钙及离子钙水平检测,6例行上消化道造影检查,8例行染色体检查,20例行心脏彩色多普勒超声检查.结果 CT扫描结果：异常21例,其中15例诊断为先天性囊肿,5例舌后坠阻塞呼吸道,1例鼻后孔闭锁（双侧）；另33例未见异常.直接喉镜检查结果：异常13例,其中12例为先天性囊肿,1例为舌后坠；另17例未见异常.电子鼻咽喉镜检查结果：5例确诊为先天性喉软骨软化症.病理检查结果：7例囊肿壁由鳞状上皮组成,1例囊肿壁由柱状上皮组成.血清总钙及离子钙水平结果：全部病例在正常范围内.上消化道造影结果：1例正常,5例轻度胃食管反流.染色体检查结果均正常.心脏超声结果：4例正常,10例卵圆孔未闭,2例动脉导管未闭,4例先天性心脏病（2例房间隔缺损,1例室间隔缺损,1例房间隔合并室间隔缺损）.结论 新生儿UAO多数以吸气性喉鸣为首发症状,除先天性喉软骨软化症外,还有很多器质性病变,其中囊肿最常见.对以喉喘鸣发病或不明原因的UAO,应尽早完善CT扫描.Objective To explore the etiology of neonatal upper airway obstruction（UAO） in order to perform early diagnosis and treatment,and to improve the prognosis.Methods Retrospectively analysis of the clinical data of 54 cases of neonatal UAO in Shengjing Hospital of China Medical University from Jan.2005 to Dec.2011 was performed.All patients received CT three dimensional reconstruction reconstruction,30 patients received the direct laryngoscopy,5 cases received the video laryngoscope,8 cases received pathological examination.All the cases received the determination of serum total calcium and ionized calcium,6 cases received upper gastrointestinal imaging,8 cases received chromosome inspection and 20 cases received echocardiography.Results CT scan：abnormal in 21 cases,among them 15 cases of congenital cyst,5 cases of tongue fall blocking airway,and 1 case of choanal atresia（bilateral） ;another 33 patients were normal.Direct laryngoscopy results：abnormal in 13 cases,among them 12 cases of congenital cyst,and 1 case of glossoptosis;another 17 cases were normal.Electronic laryngoscopy results：5 cases were diagnosed as congenital laryngomalacia.Pathological examination results：7 cases of cyst wall by squamous epithelium composition,and 1 case of cyst wall by columnar epithelium composition.Serum total calcium and ion calcium level results：all patients were in the normal range.Chromosome examination results were normal.Upper gastrointestinal imaging results：1 normal case,5 cases of mild gastroesophageal reflux.Echocardiography results：4 cases were normal,10 cases of patent foramen ovale,2 cases of patent ductus arteriosus,4 cases of congenital heart disease （2 cases of atrial septum defect,1 case of ventricular septal defect,and 1 case of interatrial septum merger ventricular septal defect）.Conclusions In the etiology of neonatal UAO,there is a lot of organic diseases except for congenital laryngomalacia.For the UAO induced by laryngeal stridor or undefinitely cause,CT scan should be taken as soon

关 键 词：上呼吸道梗阻 CT扫描 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]