Jorgensen Jeffrey, Wei Julie L, Sykes Kevin J, Klem Stephen A, Weatherly Robert A, Bruegger Daniel E, Latz Adriane D, Nicklaus Pamela J
Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA.
Otolaryngol Head Neck Surg. 2007 Sep;137(3):394-9. doi: 10.1016/j.otohns.2007.03.041.
To identify risk factors predisposing to postextubation complications and the incidence of subglottic stenosis following endotracheal intubation for bronchiolitis.
A review of 144 consecutive infants and children intubated for bronchiolitis between 2000 and 2005 at a regional children's hospital.
The mean age at diagnosis was 6.4 months. Follow-up data were available in 93 patients (64.6%), and average length of follow-up was 9.3 months. One hundred and three patients (71.5%) had positive RSV detection. Average duration of intubation was 5.5 days. Twenty-six patients (18.1%) required reintubation during the same admission. Children intubated for less than 3 days and those greater than 12 months of age were more likely to experience postextubation difficulties. Approximately 40% of patients experienced postextubation difficulties. Subglottic pathology was found on endoscopy in 6 patients (4%). There were no cases of long-term subglottic stenosis.
Immediate postextubation complications are common after bronchiolitis, especially in patients intubated for less than 3 days and greater than 12 months of age. We found no evidence of long-term subglottic stenosis in this population.
确定毛细支气管炎气管插管后发生拔管后并发症的危险因素及声门下狭窄的发生率。
回顾了2000年至2005年间在一家地区儿童医院因毛细支气管炎接受插管的144例连续的婴幼儿和儿童。
诊断时的平均年龄为6.4个月。93例患者（64.6%）有随访数据，平均随访时间为9.3个月。103例患者（71.5%）呼吸道合胞病毒检测呈阳性。平均插管时间为5.5天。26例患者（18.1%）在同一住院期间需要再次插管。插管时间少于3天和年龄大于12个月的儿童更有可能出现拔管困难。约40%的患者出现拔管困难。6例患者（4%）在内镜检查中发现声门下病变。无长期声门下狭窄病例。
毛细支气管炎后拔管后立即出现并发症很常见，尤其是插管时间少于3天和年龄大于12个月的患者。我们在该人群中未发现长期声门下狭窄的证据。
