11例新生儿先天性气管狭窄临床分析

Clinical analysis of congenital tracheal stenosis in 11 neonates

目的分析11例先天性气管狭窄(CTS)的临床资料。方法回顾性分析2016年7月至2019年10月我院收治的CTS病例11例的临床资料,并文献复习CTS的相关诊疗方案。结果11例CTS患儿中,男8例,女3例;由纤维支气管镜确诊6例,胸部CT(含气道重建)确诊5例。10例CTS患儿均有不同程度地青紫及呼吸困难,10例伴有其他部位发育异常,以喉软化和心脏畸形为主,3例胸部CT显示肺部弥漫性炎性渗出,2例合并肺实变,2例合并胸腔积液,2例出现颅内出血。结论纤维支气管镜及CT对CTS有确诊意义,合并CTS的新生儿多合并其他发育异常、肺部影像学表现较重。气管狭窄病例轻症主要为内科保守治疗,症状明显需考虑手术治疗,Slide术是目前较为理想的手术方式,而气管支架前景较为广阔。

Objective To analyze the clinical data of 11 cases of congenital tracheal stenosis(CTS).Methods The clinical data of 11 cases of neonatal tracheal stenosis were retrospectively analyzed,and the related diagnosis and treatment plans of CTS were reviewed based on literature.Results There were 8 males and 3 females in 11 cases of CTS;6 cases were diagnosed by fiberoptic bronchoscopy,and 5 cases were diagnosed by chest CT(including airway reconstruction).Ten cases of CTS had cyanosis and dyspnea of varying degrees.Ten cases had dysplasia in other parts,mainly laryngeal malacia and cardiac malformation.Chest CT showed diffuse inflammatory exudation in 3 cases,consolidation of lung in 2 cases,pleural effusion in 2 cases,and intracranial hemorrhage in 2 cases.Conclusion Fiberoptic bronchoscopy and CT are helpful in the diagnosis of CTS.Most of the neonates with CTS are complicated with other developmental abnormalities and have severe pulmonary imaging manifestations.The mild cases of tracheal stenosis are mainly treated by conservative treatment in internal medicine,and surgical treatment is necessary for those with obvious symptoms.Slide operation is an ideal surgical mode at present,and tracheal stent has a broad prospect.