小儿先天性喉裂13例诊断与治疗分析  

Pediatric laryngeal clefts：an experience in the diagnosis and management of 13 cases

作　　者：吴泽斌[1] 李兰[1] 潘宏光[1] 梁振江[1] 冼志雄[1] 张德伦[1] 滕以书[1] 马翔宇[1] 

机构地区：[1]深圳市儿童医院耳鼻咽喉科,518026

出　　处：《中华耳鼻咽喉头颈外科杂志》2017年第9期681-685,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：深圳市科技创新委员会资助项目（JCYJ20150403100317061）

摘　　要：目的 探讨先天性喉裂的诊断和治疗方法.方法 回顾性分析2007-2015年13例先天性喉裂患儿的临床资料.结果 根据Benjamin-Inglis分型,喉裂患儿包括11例Ⅰ型,1例Ⅱ型和1例Ⅲ型,所有喉裂患儿均通过全身麻醉支撑喉镜联合支气管镜确诊.11例Ⅰ型和1例Ⅱ型喉裂患儿均首选保守治疗,前者疗效满意,Ⅱ型喉裂随后行内镜修补术获得缓解,1例Ⅲ型喉裂行开放性手术但效果不佳.结论 喉裂虽然少见,但喂养困难和反复吸入性肺炎的患儿应行相关检查,尤其合并其他先天畸形时更应警惕喉裂可能.电子纤维喉镜便于对患儿进行初步筛查,支撑喉镜联合支气管镜是诊断的金标准.大部分低级别喉裂可保守治疗;符合手术适应证时,行内镜修补术成功率较高;Ⅲ、Ⅳ型喉裂常合并严重畸形和并发症,死亡率高.Objective To investigate the diagnosis and management of laryngeal cleft.MethodThe clinical data of 13 cases of laryngeal cleft treated between 2007 and 2015 was analyzed retrospectively.Results The children with laryngeal cleft were classified according to the classification of Benjamin-Inglis,as type Ⅰ（11 cases）,typeⅡ（1 case） and type Ⅲ（1 case）.All patients were confirmed by microlaryngobronchoscopy under general anaesthetic.Eleven typeⅠ and 1 type Ⅱ clefts were managed conservatively,with which all type Ⅰ patients were successfully managed,while the type Ⅱ patient was resolved by surgical endoscopy.The type Ⅲ patient was treated by open repair but the results was poor.Conclusions Patients who suffered with choking on feeding or recurrent aspiration pneumonia,especially coexisted with other congenital malformation,needed detailed evaluation for laryngeal cleft,although which was a rare congenital abnormality.Electronic laryngoscope could be the first step to screen the cleft,while microlaryngobronchoscopy is the gold standard for diagnosis of laryngeal cleft.The majority of children with lower type clefts can be managed conservatively.Surgical endoscopy has high success rate when strictly following the indication.Type Ⅲ and Ⅳ clefts have high mortality for usually combining with severe complications and abnormalities.

关 键 词：喉裂 肺炎 吸入性 喉镜 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]