气管插管导致小儿喉气管狭窄的临床特点

Clinical characteristics of laryngotracheal stenosis in children caused by tracheal intubation

目的分析气管插管导致小儿喉气管狭窄的临床特点。方法回顾性分析全身麻醉(全麻)下行支撑喉镜内镜下手术的40例气管插管导致喉气管狭窄患儿的临床资料。结果①首次插管原因:外科手术因素最多,为22例(55.0%);气管导管留置时间均>24 h;年龄<1岁28例(70.0%);气管导管型号偏大17例(42.5%);多次插管或换管24例(60.0%);再次行内镜手术17例(42.5%);30 d再入院患儿13例(32.5%)。②术后转归:32例(80.0%)临床治愈,4例(10.0%)病情好转,3例(7.5%)行气管切开;1例(2.5%)因原发病为嗜血细胞综合征,气管问题解除后家属要求自动出院。无住院期间死亡病例。结论小儿气管插管导致的喉气管狭窄容易复发、不易治愈,应最大限度避免气管损伤,预防该疾病的发生。

Objective To analyze the clinical characteristics of laryngotracheal stenosis in children caused by tracheal intubation.Methods The clinical data of 40 children with laryngotracheal stenosis due to tracheal intubation under general anesthesia for supported laryngoscopic endoscopic surgery was retrospectively analyzed.Results①Reasons for first intubation:surgical factors were the most frequent in 22 cases(55.0%);all tracheal tubes were left in place for>24 h;28 cases(70.0%)were aged<1 year;17 cases(42.5%)had large tracheal tubes;24 cases(60.0%)were intubated or reintubated several times;17 cases(42.5%)had endoscopic hands again;and 13 cases(32.5%)were readmitted at 30 d.②Postoperative regression:32 cases(80.0%)were clinically cured,4 cases(10.0%)improved,and 3 cases(7.5%)underwent tracheotomy;1 case(2.5%)with primary disease as hemophagocytic syndrome was discharged automatically at the request of the family after the tracheal problem was relieved.There were no cases of death during hospitalization.Conclusion Laryngotracheal stenosis caused by tracheal intubation in children is easy to relapse and hard to cure,so airway damage should be avoided to the greatest extent to prevent the occurrence of this disease.