先天性气管狭窄气道形态评估和早期预后的相关性  

The early-phase prognostic role of preoperative evaluation in congenital tracheal stenosis

作　　者：杜舟[1] 朱丽敏[1] 刘金龙 刘锦纷[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心心胸外科,200127

出　　处：《中华胸心血管外科杂志》2015年第8期494-498,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的 分析外科手术治疗后先天性气管狭窄（CTS）患儿的早期生存情况,探讨术前气道形态的评估与早期预后的关系.方法 回顾性分析2007年4月至2013年6月CTS患儿的临床资料.选择狭窄程度、狭窄长度、术前分型等因素,应用SPSS 19.0分析影响患儿早期预后的因素.结果 52例CTS患儿的术后3个月生存率为73.1％,死亡14例.Log-rank检验和Cox多因素分析显示,狭窄程度和术前Anton-Pacheco分型与患儿早期预后相关,为影响患儿预后的独立影响因素（P＜0.05）.狭窄长度、Cantrell分型和术前感染情况与早期预后无明显相关性（P＞0.05）.死亡组的体外循环（CPB）时间明显长于生存组（P＜0.05）.结论 气管狭窄程度和Anton-Pacheco分型可能会显著影响CTS患儿的早期术后生存,当狭窄程度大于80％,患儿早期生存率可能会显著下降.准确的术前评估对判断CTS患儿的早期预后具有重要的意义.Objective To explore the preoperative assessment of airway morphology affecting the early-phase prognosis by observing congenital tracheal stenosis survival after surgical treatment.Methods Totally 52 cases of CTS surgically treated in the Shanghai children＇s Medical Center,from April 2007 to June 2013,were retrospectively analyzed to study their clinical characteristics,survival condition and related factors influencing the early-phase prognosis.Using log-rank test and Cox multiple factors analysis for statistical analysis.Results Overall postoperative survival rate of 3 months was 73.1%.There were 14 deaths among 48 patients.Single factor and multiple factors analysis showed that the cross-sectional area（CSA） of stenosis and Anton-Pacheco classification were both associated with early-phase prognosis as independent factors（P 〈0.05）.Long CPB duration was a prognostic factor for the outcome of surgical treatment for CTS（P 〈 0.05）.CPB time was significantly longer in death cases than in surviving cases.Conclusion CSA and Anton-Pacheco classification were significant prognostic factors for CTS.The proper utilization of radiologic imaging allow for improved patient care.

关 键 词：气管狭窄 体层摄影术 螺旋计算机 预后 生存 

分 类 号：R726.2[医药卫生—儿科]