双H型先天性气管食管瘘2例并文献复习  

Double H-type congenital tracheoesophageal fistulas:two cases report and literature review

作　　者：刘芸 余宏川[1] 孙欣荣[1] 陈伟超[1] 杨婷婷 Liu Yun;Yu Hongchuan;Sun Xinrong;Chen Weichao;Yang Tingting(Department of Respiratory,Xi′an Children′s Hospital,Xi′an 710003,Shaanxi Province,China)

机构地区：[1]西安市儿童医院呼吸一科,西安710003

出　　处：《中华妇幼临床医学杂志（电子版）》2024年第2期216-223,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的探讨双H型先天性气管食管瘘(DCTEFs)患儿的临床特点。方法选择西安市儿童医院收治的2例DCTEFs患儿(患儿1、2)为研究对象。采用回顾性分析方法,对这2例患儿的临床资料、诊疗方案进行分析。以“气管食管瘘”“H型气管食管瘘”“双气管食管瘘”“双H型气管食管瘘”“V型食管闭锁”“单纯性气管食管瘘”“食管气管瘘”为中文主题词,在中国知网、万方数据库中进行文献检索;再以“tracheoesophageal fistula”“H-type tracheoesophageal fistula”“double H-type tracheoesophageal fistula”“double tracheoesophageal fistula”“Ⅴ-type esophageal atresia”为英文主题词,在PubMed、Embase等英文数据库中进行文献检索。检索时间设定为1952年1月至2022年11月。结果①患儿1(4个月2 d龄)以生后呛奶、吐奶、反复呼吸道感染为主要表现,于2018年8月29日入本院治疗。患儿2(2岁11个月)以生后呛咳伴呕吐、反复呼吸道感染为主要表现,于2020年3月24日入本院治疗。对2例患儿进行支气管镜检查均发现2个H型气管食管瘘,并进行内镜下气管食管瘘封堵术(TFC),使用氩气刀灼烧食管内侧瘘口周围黏膜,患儿1治愈,患儿2于术后8个月复发。②根据本研究设定的检索策略,共检索出10篇相关文献,纳入共计10例DCTEFs患儿诊疗研究。其中,7例患儿(患儿4、6~10、12)临床病例资料相对完整,临床表现均为进食后发绀、呛咳、吐奶或腹胀等呼吸道及消化道症状,1例(患儿12)有反复呼吸道感染史。这10例患儿中,仅1例(患儿5)的食管造影术结果显示2个瘘口,对3例(患儿7、9、12)采取支气管镜检查均发现2个瘘口,对1例(患儿11)采取支气管镜联合胃镜检查发现2个瘘口,1例(患儿3)尸检发现2个瘘口,1例(患儿4)尸检发现第2个瘘口,3例(患儿6、8、10)在术中或术后均发现第2个瘘口。4例(患儿6~8、10)采取开放性手术治愈,1例(患儿12)采取胸腔镜手术�Objective To investigate the clinical characteristics of children with double H-type congenital tracheoesophageal fistulas(DCTEFs).Methods Two cases of DCTEFs(patient 1 and 2)treated at Xi′an Children′s Hospital were selected in this study.A retrospective analysis was conducted to examine the clinical data,diagnostic methods,and treatment plans for these two patients.Literature searches were performed in Chinese databases such as CNKI and Wanfang using Chinese keywords including"tracheoesophageal fistula""H-type tracheoesophageal fistula""double tracheoesophageal fistula""double H-type tracheoesophageal fistula""V-type esophageal atresia""simple tracheoesophageal fistula"and"esophageal tracheal fistula".Additionally,English databases in PubMed and Embase were searched using English keywords such as"tracheoesophageal fistula""H-type tracheoesophageal fistula""double H-type tracheoesophageal fistula""double tracheoesophageal fistula"and"V-type esophageal atresia".The search period was set from January 1952 to November 2022.Results①Patient 1(4 months and 2 days old)was admitted to our hospital on August 29,2018,with symptoms of choking on milk,vomiting,and recurrent respiratory infections after birth.Patient 2(2 years and 11 months old)was admitted on March 24,2020,with symptoms of choking cough,vomiting,and recurrent respiratory infections after birth.Both patients underwent bronchoscopy and were found to have two H-type tracheoesophageal fistulas.They both underwent endoscopic tracheoesophageal fistula closure(TFC),with argon beam coagulation of the mucosa around the inner fistula of the esophagus.Patient 1 was cured,while patient 2 experienced a recurrence 8 months after surgery.②According to the search strategies established in this study,a total of 10 relevant articles were retrieved,involving 10 cases with DCTEFs.Among them,7 patients(patients 4,6-10,12)had relatively complete clinical case data,all showing respiratory and gastrointestinal symptoms,such as cyanosis after feeding,choking cough,vomiting,

关 键 词：气管食管瘘 先天性 双H型气管食管瘘 支气管镜 气管食管瘘封堵术 儿童 

分 类 号：R725.8[医药卫生—儿科]