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小儿声门下狭窄的部分环状气管切除术:单机构60例经验

Partial cricotracheal resection for pediatric subglottic stenosis: a single institution's experience in 60 cases.

作者信息

Monnier P, Lang F, Savary M

机构信息

Department of Otolaryngology and Head and Neck Surgery, University Hospital, CHUV, 1011 Lausanne, Switzerland.

出版信息

Eur Arch Otorhinolaryngol. 2003 Jul;260(6):295-7. doi: 10.1007/s00405-002-0465-y. Epub 2002 Dec 24.

Abstract

In our study, 60 infants and children, each with a severe subglottic stenosis (SGS), underwent partial cricotracheal resection (PCTR) with primary thyrotracheal anastomosis. According to the Myer-Cotton classification, two were grade II, 41 were grade III and 17 were grade IV stenoses. Of the 60 patients, 57 (95%) are presently decannulated, and one patient sustained a complete restenosis. Two patients with better than 80% subglottic airways still are waiting for decannulation: one because of bilateral cricoarytenoid joint fixation and the second because of temporary stenting of the subglottis with a Montgomery T-tube. The rate of decannulation is 97% (36 of 37 cases) in primary PCTRs, 100% (13 of 13 cases) in salvage PCTRs for failed laryngotracheal reconstructions (LTR) and 70% (7 of 10 cases) in extended PCTRs (i.e., PCTR associated with an additional open-airway procedure).

摘要

在我们的研究中,60例患有严重声门下狭窄(SGS)的婴幼儿接受了部分环状气管切除术(PCTR)并进行了一期甲状腺气管吻合术。根据迈耶-科顿分类法,2例为Ⅱ级狭窄,41例为Ⅲ级狭窄,17例为Ⅳ级狭窄。60例患者中,57例(95%)目前已拔除气管套管,1例患者出现完全再狭窄。2例声门下气道通畅率超过80%的患者仍在等待拔除气管套管:1例是因为双侧环杓关节固定,另1例是因为使用蒙哥马利T型管对声门下进行临时支架置入。一期PCTR的拔管率为97%(37例中的36例),喉气管重建(LTR)失败后挽救性PCTR的拔管率为100%(13例中的13例),扩大性PCTR(即与额外的气道开放手术相关的PCTR)的拔管率为70%(10例中的7例)。

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