婴儿中重度喉软化症临床转归及中长期随访研究  

Long term outcomes of infants with moderate to severe laryngomalacia

作　　者：梁穗新[1] 何少茹[1] 桂娟[1] 孙云霞[1] 钟劲[1] 余宇晖[1] 王一飞[1] 

机构地区：[1]广东省人民医院(广东省医学科学院)新生儿科,广州510080

出　　处：《中国小儿急救医学》2017年第4期278-281,共4页Chinese Pediatric Emergency Medicine

基　　金：广东省自然科学基金（2014A030313546）

摘　　要：目的评估伴发畸形的婴儿喉软化症的转归及中长期预后情况，探讨婴儿喉软化症的临床管理规范。方法回顾性收集2013年1月至2015年12月在我院确诊的中一重度喉软化症婴幼儿的临床资料及随访结果。将这些患儿分为伴发畸形组（37例）及不伴发畸形组（19例）。结果56例喉软化患儿纳入研究。伴发畸形组呼吸症状消失月龄[（10．00±3．56）个月]大于不伴发畸形组[（7．89±3．03）个月]，差异有统计学意义（P〈0．05）。伴发畸形组患儿在确诊后3、6及12个月时的体重百分位明显低于不伴发畸形组（P〈0．05）。而确诊后24个月两组患儿的体重百分位比较差异无统计学意义。伴发畸形组共有5例患儿接受声门上成形术，其中1例最终需行气管切开术；不伴发畸形组共有3例患儿接受声门上成形术。结论中一重度喉软化患儿呼吸症状及体格发育落后均可随月龄增长而逐渐改善，目前没有证据提示伴发畸形的此类患儿需要更积极的声门上成形术。Objective To determine the long term outcomes of laryngomalacia infants with anoma- lies and to determine the clinical practice guideline for these infants. Methods The charts of infants with moderate to severe laryngomalacia, who were admitted to our hospital between January 2013 and December 2015, were retrospectively reviewed. These infants were divided into two groups, anomaly（A） group（ n = 37 ） and non-anomaly （NA） group （n = 19 ）. Results Fifty-six cases were enrolled. Infants in A group were older at symptom relief than those in NA group [ （ 10. 00 _＋ 3.56 ） months vs. （ 7. 89 _＋ 3.03 ） months, P 〈 0. 051 ,and the weight percentiles of infants in A group were lower at 3,6 and 12 months than those in NA group（ P 〈 0. 05 ）. There was no statistically significant difference between the two groups on the weights percentiles in infants at 24 months after diagnosis. Five of 37 cases in A group and 3 of 19 cases in NA group had supraglottoplasty. One infant in A group had tracheotomy. Conclusion Both breathing difficulty and development retardations of infants with moderate or severe laryngomalacia could gradually improved with age. There is not enough evidence to support the aggressive supraglottoplasty for infants with anomalies and laryngomalacia.

关 键 词：喉软化 并发畸形 手术治疗 体格发育. 

分 类 号：R767[医药卫生—耳鼻咽喉科]