儿童声带麻痹207例临床分析  

Clinical evaluation of vocal fold paralysis in 207children

作　　者：段博 倪祎华 戴玉琼[1] 许政敏[1] Duan Bo;Ni Yihua;Dai Yuqiong;Xu Zhengmin(Department of Otorhinolaryngology Head and Neck Surgery,Children's Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院耳鼻咽喉头颈外科,上海201102

出　　处：《中华耳鼻咽喉头颈外科杂志》2018年第11期847-850,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的探讨儿童左侧、右侧和双侧声带麻痹的病因、临床特点及预后。方法回顾性分析2009年9月至2016年11月复旦大学附属儿科医院耳鼻咽喉头颈外科收治的207例声带麻痹患儿的临床资料,总结其发病原因、临床特点及预后。对定量数据采取Wilcoxon Rank-Sum Test,对定性数据采用χ2检验。结果207例患儿均有不同程度的声嘶。左侧声带麻痹患儿151例(72.9%),其中先天性心脏病患儿139例,主要为肺动脉高压和肺动脉扩张,77.0%(107/139)可治愈或好转,预后较好。双侧声带麻痹患儿43例(20.8%),其中先天性气管食管畸形15例,其主要病因可能为先天发育异常,预后较差,需要气管插管或气管切开等对症支持治疗。右侧声带麻痹患儿13例(6.3%),其中8例由颅内病变引起,因起病快,病情严重,预后较差;喉外肿瘤和特发性病因为次要原因。结论儿童左侧声带麻痹主要病因为先天性心脏病,应首先进行心血管方面检查,明确原发病;双侧声带麻痹主要病因可能为先天发育异常,应尽早行颈部、胸部影像学等相关检查并积极对症支持治疗;右侧声带麻痹病因主要以颅脑病变为主,预后较差,应密切随访从头颅至纵隔的相关影像学检查,针对病因治疗及对症支持。Objective To investigate the etiology and clinical characteristics of vocal fold paralysis in children. To provide useful information for diagnosis , management and prognosis in the clinical work.Methods Two hundred and seven children with vocal fold paralysis in Children's Hospital of Fudan University were retrospectively studied , and followed-up.Results All the patients had hoarseness .151 cases had vocal paralysis in the left side and the main etiology was pulmonary arterial hypertension .43 cases had bilateral vocal paralysis and all of them had respiratory problems .The main etiology were congenital tracheoesophageal malformations .13 cases had vocal paralysis in the right side .In terms of etiology , 8 cases were related to intracranial lesions , 2 cases were idiopathic.Conclusions The main etiologies of left vocal fold paralysis were cardiovascular diseases , and bilateral vocal paralysis were congenital tracheoesophageal malformations.The main etiologies of right vocal fold paralysis were neoplastic and central lesion .The prognosis of bilateral vocal fold paralysis and right vocal fold paralysis was poor .

关 键 词：儿童 声带麻痹 病因 预后 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]