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食管闭锁患儿的乳胶过敏

Latex allergy in children with oesophageal atresia.

作者信息

Gentili A, Ricci G, Di Lorenzo F P, Pigna A, Masi M, Baroncini S

机构信息

Department of Paediatric Anaesthesia and Intensive Care, S. Orsola-Malpighi Hospital, Bologna University, Italy.

出版信息

Paediatr Anaesth. 2003 Oct;13(8):668-75. doi: 10.1046/j.1460-9592.2003.01118.x.

Abstract

BACKGROUND

Latex allergy is frequently found in children and patients with spina bifida and urogenital abnormalities and have been considered at risk for latex sensitization. The aim of the study was to evaluate the incidence of latex sensitization in patients with oesophageal atresia and undergoing three or more surgical procedures and to identify possible risk factors in the process of latex sensitization.

METHODS

A total of 20 patients were analysed: 19 boys and one girl. The oesophageal atresias were as follows: type I in three children, type II in two and type III in 15 children. Surgical and anaesthetic procedures, intensive care management, age, type of oesophageal atresia, associated congenital malformations, Waterston and Montreal prognostic classifications were considered as risk factors that may be implicated in the process of sensitization.

RESULTS

Five patients (25%) were considered sensitized to latex (group 1) and 15 (75%) nonsensitized (group 2). Among the five sensitized patients, three reported clinical reactions to latex, while the other two presented only specific IgE sensitization. The number of operations, the total hours of surgery, the number of drainages, the total days of drainage, the total days of central venous catheter were significantly greater in group 1 than in group 2. Both of the highest risk oesophageal atresia classes (Waterston C and Montreal II) were related to latex allergy.

CONCLUSIONS

Oesophageal atresia, especially in cases of prolonged management, must be considered as a risk for the development of latex allergy.

摘要

背景

乳胶过敏在儿童以及脊柱裂和泌尿生殖系统异常的患者中很常见,这些患者被认为有乳胶致敏的风险。本研究的目的是评估食管闭锁且接受三次或更多次外科手术的患者中乳胶致敏的发生率,并确定乳胶致敏过程中可能的风险因素。

方法

共分析了20例患者:19名男孩和1名女孩。食管闭锁情况如下:I型3例,II型2例,III型15例。手术和麻醉操作、重症监护管理、年龄、食管闭锁类型、相关先天性畸形、沃特斯顿和蒙特利尔预后分类被视为可能与致敏过程有关的风险因素。

结果

5例患者(25%)被认为对乳胶致敏(第1组),15例(75%)未致敏(第2组)。在5例致敏患者中,3例报告有乳胶临床反应,另外2例仅表现为特异性IgE致敏。第1组的手术次数、手术总时长、引流管数量、引流总天数、中心静脉导管留置总天数均显著多于第2组。两种最高风险的食管闭锁类型(沃特斯顿C型和蒙特利尔II型)均与乳胶过敏有关。

结论

食管闭锁,尤其是在长期治疗的情况下,必须被视为发生乳胶过敏的一个风险因素。

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