The management of the congenital esophageal stenosis is not well established. The authors present an infant with critical esophageal stenosis owing to tracheo bronchial remnant. This lesion was managed successfully by...The management of the congenital esophageal stenosis is not well established. The authors present an infant with critical esophageal stenosis owing to tracheo bronchial remnant. This lesion was managed successfully by circular myectomy of the esophageal wall without resection. An 1-year-old girl was referred for rec urrent vomiting and dysphagia. An esophagogram showed an abrupt stenosis, and en doscopic ultrasonography showed cartilaginous tracheo bronchial remnants within the esophageal wall. The extirpation of muscular lay er, which contained cartilage, was attempted. Circular muscular layer was resect ed in 1 cm width leaving mucosal layer intact. Muscular layer was closed horizon tally with absorbable sutures. The patient is free from the symptoms and eats no rmally 1 year after surgery. In case of short segmental stenosis owing to trache obronchial remnant, this may be the preferred approach.展开更多
目的探讨肺力咳合剂联合阿奇霉素治疗小儿肺炎支原体气管炎(mycoplasma pneumoniae bronchitis,MPB)的效果及对肺功能和辅助T细胞1型/辅助T细胞2型(T helper cell type 1/T helper cell type 2,Th1/Th2)平衡的影响。方法选取确诊的75例...目的探讨肺力咳合剂联合阿奇霉素治疗小儿肺炎支原体气管炎(mycoplasma pneumoniae bronchitis,MPB)的效果及对肺功能和辅助T细胞1型/辅助T细胞2型(T helper cell type 1/T helper cell type 2,Th1/Th2)平衡的影响。方法选取确诊的75例MPB患儿,采用随机数字表法分为观察组(38例)和对照组(37例)。对照组口服阿奇霉素治疗,观察组在对照组治疗的基础上口服肺力咳合剂,2组患儿的疗程均为7 d。治疗结束后比较2组患儿的治疗有效率、症状消失时间、总症状积分、肺功能、Th1/Th2平衡、血清C反应蛋白(C-reactive protein,CRP)、血沉(erythrocyte sedimentation rate,ESR)和不良反应发生率。结果观察组的治疗有效率高于对照组(P<0.05);观察组治疗后的症状消失时间即平均退热时间及平均咳嗽消失时间短于对照组(P<0.05);观察组治疗后的咳嗽、喘息和发热积分低于对照组(P<0.05);观察组治疗后的潮气量(tidal volume,V-T)、达峰时间比(ratio of time to peak tidal expiratory flow to time of expiratory,t-PTEF/t-E)、用力呼气25%流速(maximal expiratory flow at 25%,MEF25)和最大呼气中段流速(maximum mid-expiratory flow rate,MEF25-75)高于对照组(P<0.05);观察组治疗后的干扰素-γ(interferon-γ,IFN-γ)、白细胞介素-4(interleukin-4,IL-4)和白细胞介素-6(interleukin-6,IL-6)低于对照组,白细胞介素-2(interleukin-2,IL-2)高于对照组(P<0.05);观察组治疗后的CRP和ESR低于对照组(P<0.05);观察组治疗后的不良反应发生率低于对照组,2组比较差异无统计学意义。结论肺力咳合剂联合阿奇霉素治疗MPB可有效改善患者的肺功能和Th1/Th2平衡情况。展开更多
文摘The management of the congenital esophageal stenosis is not well established. The authors present an infant with critical esophageal stenosis owing to tracheo bronchial remnant. This lesion was managed successfully by circular myectomy of the esophageal wall without resection. An 1-year-old girl was referred for rec urrent vomiting and dysphagia. An esophagogram showed an abrupt stenosis, and en doscopic ultrasonography showed cartilaginous tracheo bronchial remnants within the esophageal wall. The extirpation of muscular lay er, which contained cartilage, was attempted. Circular muscular layer was resect ed in 1 cm width leaving mucosal layer intact. Muscular layer was closed horizon tally with absorbable sutures. The patient is free from the symptoms and eats no rmally 1 year after surgery. In case of short segmental stenosis owing to trache obronchial remnant, this may be the preferred approach.
文摘目的探讨肺力咳合剂联合阿奇霉素治疗小儿肺炎支原体气管炎(mycoplasma pneumoniae bronchitis,MPB)的效果及对肺功能和辅助T细胞1型/辅助T细胞2型(T helper cell type 1/T helper cell type 2,Th1/Th2)平衡的影响。方法选取确诊的75例MPB患儿,采用随机数字表法分为观察组(38例)和对照组(37例)。对照组口服阿奇霉素治疗,观察组在对照组治疗的基础上口服肺力咳合剂,2组患儿的疗程均为7 d。治疗结束后比较2组患儿的治疗有效率、症状消失时间、总症状积分、肺功能、Th1/Th2平衡、血清C反应蛋白(C-reactive protein,CRP)、血沉(erythrocyte sedimentation rate,ESR)和不良反应发生率。结果观察组的治疗有效率高于对照组(P<0.05);观察组治疗后的症状消失时间即平均退热时间及平均咳嗽消失时间短于对照组(P<0.05);观察组治疗后的咳嗽、喘息和发热积分低于对照组(P<0.05);观察组治疗后的潮气量(tidal volume,V-T)、达峰时间比(ratio of time to peak tidal expiratory flow to time of expiratory,t-PTEF/t-E)、用力呼气25%流速(maximal expiratory flow at 25%,MEF25)和最大呼气中段流速(maximum mid-expiratory flow rate,MEF25-75)高于对照组(P<0.05);观察组治疗后的干扰素-γ(interferon-γ,IFN-γ)、白细胞介素-4(interleukin-4,IL-4)和白细胞介素-6(interleukin-6,IL-6)低于对照组,白细胞介素-2(interleukin-2,IL-2)高于对照组(P<0.05);观察组治疗后的CRP和ESR低于对照组(P<0.05);观察组治疗后的不良反应发生率低于对照组,2组比较差异无统计学意义。结论肺力咳合剂联合阿奇霉素治疗MPB可有效改善患者的肺功能和Th1/Th2平衡情况。
