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[严重胎儿气道阻塞管理中的EXIT手术。儿科耳鼻喉科医生的视角]

[EXIT procedure in the management of severe foetal airway obstruction. the paediatric otolaryngologist's perspective].

作者信息

Pellicer Marc, Pumarola Félix, Peiró José Luis, Martínez Ibáñez Vicente, García Vaquero Juan Antono, Carreras Elena, Manrique Susana, Vinzo Joan, Perelló Enrique

机构信息

Sección de Otorrinolaringología Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona. España.

出版信息

Acta Otorrinolaringol Esp. 2007 Dec;58(10):487-90.

Abstract

The ex-utero intrapartum treatment (EXIT) procedure is a technique designed to allow partial foetal delivery via caesarean section with establishment of a safe foetal airway by either intubation, bronchoscopy, or tracheostomy while foetal oxygenation is maintained through utero-placental circulation. The most common indication for the EXIT procedure is the presence of foetal airway obstruction, which is usually caused by a prenatal diagnosed neck mass. We report three cases of head and neck tumours with airway obstruction treated by means of EXIT and with different solutions in the management of the airway. With the involvement of Paediatric Otolaryngologists in EXIT, new indications and select variations from the standard EXIT protocol should be considered.

摘要

宫外产时处理(EXIT)手术是一种技术,旨在通过剖宫产实现部分胎儿娩出,同时通过插管、支气管镜检查或气管造口术建立安全的胎儿气道,而胎儿氧合通过子宫-胎盘循环得以维持。EXIT手术最常见的指征是胎儿气道梗阻,这通常由产前诊断出的颈部肿块引起。我们报告了3例因气道梗阻接受EXIT手术治疗且在气道管理方面采用不同解决方案的头颈部肿瘤病例。随着儿科耳鼻喉科医生参与EXIT手术,应考虑新的指征以及与标准EXIT方案的选择差异。

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