新生儿声嘶78例病因分析

Etiological Analysis of 78 Case of Neonatal Hoarseness

目的探讨新生儿声嘶的病因。方法回顾性分析2018年1月至2023年3月因声嘶在首都医科大学附属北京儿童医院行喉镜检查的新生儿78例。所有患儿行反流检查评分症状(reflux finding score,RFS)评分,结合病史分析病因。结果78例患儿中,诊断为声带肥厚23例(29.49%),声带小结12例(15.38%),单侧声带麻痹30例(38.46%),先天性喉蹼5例(6.41%),其他诊断包括先天性喉气管食管裂、急性喉炎、喉囊肿等。患儿常见的合并症为新生儿肺炎23例(29.49%),喉软化15例(19.23%)及新生儿高胆红素血症13例(16.67%)。此外,在导致新生儿声嘶的病因中,声带增生性疾病的RFS评分较高,差异有统计学意义。结论引起新生儿声嘶的病因以声带增生性疾病多见,其次为声带麻痹。声带增生性疾病的发生可能与咽喉反流相关。

Objective To research the causes of the hoarseness in neonate.Methods A total of 78 neonates who underwent laryngoscopy in Beijing Children's Hospital for hoarseness from January 2018 to March 2023 were retrospectively analyzed.All subjects were established the reflux finding score(RFS),and analyzed the etiology of hoarseness in combination with medical history.Results In 78 cases,vocal cord hypertrophy was diagnosed in 23 cases(29.49%),vocal nodule in 12 cases(15.38%),unilateral vocal cord paralysis in 30 cases(38.46%)and congenital laryngeal web in 5 cases(6.41%).Other diagnoses included congenital laryngotracheal esophageal fissure,acute laryngitis and laryngeal cyst.The common complications were neonatal pneumonia(29.49%),laryngeal softening(19.23%)and neonatal hyperbilirubinemia(16.67%).In addition,among the causes of neonatal hoarseness,patients with vocal nodules and vocal cord hypertrophy had a statistically significant higher RFS score.Conclusion Vocal cord proliferative diseases are the most common cause of neonatal hoarseness,followed by vocal cord paralysis.The occurrence of vocal cord proliferative disease may be related to pharyngeal reflux.