颈内/颈外入路环状软骨前/后裂开自体肋软骨移植联合T管植入治疗儿童喉气管狭窄  

Treatment of laryngotracheal stenosis in children by internal/external cervical approach anterior/posterior split of cricoid cartilage combined with autologous costal cartilage transplantation and T-tube implantation

作　　者：李宏彬 王桂香[1] 赵靖[1] 王华[1] 段清川 张丰珍 倪鑫[1] 张杰[1] LI Hongbin;WANG Guixiang;ZHAO Jing;WANG Hua;DUAN Qingchuan;ZHANG Fengzhen;NI Xin;ZHANG Jie(National Center for Children’s Health(NCCH),Beijing,Department of Otolaryngology Head and Neck Surgery,Beijing Children’s Hospital Affiliated to Capital Medical University,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery,Beijing,100045,China)

机构地区：[1]国家儿童医学中心(北京),首都医科大学附属北京儿童医院耳鼻咽喉头颈外科,儿童耳鼻咽喉头颈外科疾病北京市重点实验室,北京100045

出　　处：《中国耳鼻咽喉头颈外科》2024年第5期321-325,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨环状软骨前/后裂开自体肋软骨移植对儿童喉气管狭窄的治疗效果。方法回顾性分析首都医科大学附属北京儿童医院近年来采用环状软骨前/后裂开自体肋软骨移植联合T管植入治疗儿童喉气管狭窄12例。男5例,女7例,患儿年龄2岁6月~16岁9月,平均8岁9月。Ⅱ度狭窄2例,Ⅲ度狭窄9例,Ⅳ度狭窄1例。所有病例术前已行气管切开。病程4个月~6年,平均3年。结果10例(83.3%)患儿已治愈,成功拔除气管切开套管,恢复正常呼吸及发音功能。2例拔管失败,其中1例Ⅲ度狭窄和1例Ⅳ度狭窄。结论儿童喉气管狭窄病因复杂,治疗困难,颈内/颈外入路环状软骨前/后裂开自体肋软骨移植联合T管植入治疗儿童喉气管狭窄可取得良好的治疗效果。OBJECTIVE To investigate the therapeutic effect of autologous costal cartilage transplantation with anterior/posterior split of cricoid cartilage on laryngotracheal stenosis in children.METHODS A retrospective analysis of 12 cases of laryngotracheal stenosis in children treated with anterior/posterior split of cricoid cartilage combined with T-tube implantation in Beijing Children’s Hospital Affiliated to Capital Medical University in recent years.There were 5 males and 7 females,aged from 2 years and 6 months to 16 years and 9 months,with an average age of 8 years and 9 months.There were 2 cases of grade II stenosis,9 cases of grade III stenosis and 1 case of grade IV stenosis.All cases underwent tracheotomy before operation.The course of disease ranged from 4 months to 6 years,with an average of 3 years.RESULTS Of the 12 patients,10(83.3%)were cured,and the tracheotomy cannula was successfully removed to restore normal breathing and pronunciation function.There were 2 cases of extubation failure,including 1 case of grade III stenosis and 1 case of grade IV stenosis.CONCLUSION The etiology of laryngotracheal stenosis in children is complex and difficult to treat.Anterior/posterior split costal cartilage transplantation combined with T-tube implantation through internal/external cervical approach can achieve good therapeutic effect in the treatment of laryngotracheal stenosis in children.

关 键 词：儿童 气管狭窄 环状软骨 肋软骨 移植 喉 

分 类 号：R72[医药卫生—儿科]