Takemura Hiroshi, Yasumoto Kazumasa, Toi Takashi, Hosoyamada Akiyoshi
Department of Anaesthesiology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan.
Paediatr Anaesth. 2002 Sep;12(7):585-8. doi: 10.1046/j.1460-9592.2002.00906.x.
A retrospective survey of 339 infants who had undergone primary plastic surgery for cleft lip and palate was performed to evaluate the concomitant preoperative assessment based on severity grading of the common cold and the correlation of cleft type with the incidence of perioperative respiratory complications.
We assessed the severity of common cold symptoms in the preoperative period using the Common Cold Score, which comprises 10 symptoms and findings. We then determined the association of the incidence of perioperative respiratory complications with the increasing severity of common cold symptoms and also compared the complication incidence in the three cleft types in healthy infants without a common cold.
The incidence of perioperative respiratory complications was greater in the group with a suspected presence of a common cold. Infants with severer cleft, who had bilateral cleft lip and palate, even without common cold symptoms, had a significantly higher incidence of perioperative respiratory complications (8.9%) than infants with simple cleft lip (1.7%, P < 0.05).
Clinicians should consider postponing primary plastic surgery for cleft lip and palate in infants with a suspected presence of a common cold. Our results also suggest that the presence of a wide cleft is a risk factor for causing perioperative respiratory complications in infants with cleft lip and palate. We believe that a careful preoperative assessment of common cold symptoms in these infants can decrease the incidence of perioperative respiratory complications.
对339例接受唇腭裂一期整形手术的婴儿进行回顾性调查，以评估基于普通感冒严重程度分级的术前评估情况，以及腭裂类型与围手术期呼吸道并发症发生率的相关性。
我们使用包含10种症状和体征的普通感冒评分来评估术前普通感冒症状的严重程度。然后，我们确定围手术期呼吸道并发症发生率与普通感冒症状严重程度增加之间的关联，并比较了无普通感冒的健康婴儿三种腭裂类型中的并发症发生率。
疑似患有普通感冒的组围手术期呼吸道并发症发生率更高。患有双侧唇腭裂的严重腭裂婴儿，即使没有普通感冒症状，其围手术期呼吸道并发症发生率（8.9%）也显著高于单纯唇裂婴儿（1.7%，P<0.05）。
临床医生应考虑推迟对疑似患有普通感冒的婴儿进行唇腭裂一期整形手术。我们的结果还表明，宽腭裂的存在是导致唇腭裂婴儿围手术期呼吸道并发症的一个危险因素。我们认为，对这些婴儿术前仔细评估普通感冒症状可降低围手术期呼吸道并发症的发生率。
