Clevenger F W, Othersen H B, Smith C D
Department of Surgery, Medical University of South Carolina, Charleston.
Ann Thorac Surg. 1990 Oct;50(4):524-8; discussion 529. doi: 10.1016/0003-4975(90)90182-6.
We have performed aortopexy in 12 children with tracheal compression. Six infants had compression secondary to a vascular anomaly (group 1), and the other 6 had previous repair of esophageal atresia (group 2). Eleven of the 12 children are alive after a mean follow-up of 36 months. In group 1, 1 patient died and 3 patients (50%) experienced recurrent respiratory distress. Five infants sustained a major postoperative complication, and the average postoperative hospital stay was 25 days. In group 2, however, aortopexy was uniformly successful. There were no deaths, no postoperative complications, and no cases of postoperative respiratory distress, and the mean postoperative hospital stay was only 10 days. For children with reflex apnea after repair of esophageal atresia, aortopexy is lifesaving and can be performed with minimal morbidity and mortality. Great caution is indicated in children with tracheal compression from other causes.
我们对12例气管受压的儿童进行了主动脉固定术。6例婴儿因血管异常导致气管受压(第1组),另外6例曾接受过食管闭锁修复术(第2组)。12例儿童中的11例在平均随访36个月后仍存活。在第1组中,1例患者死亡,3例患者(50%)出现反复呼吸窘迫。5例婴儿发生了严重的术后并发症,术后平均住院时间为25天。然而,在第2组中,主动脉固定术均获成功。无死亡病例,无术后并发症,无术后呼吸窘迫病例,术后平均住院时间仅为10天。对于食管闭锁修复术后出现反射性呼吸暂停的儿童,主动脉固定术可挽救生命,且手术 morbidity 和 mortality 极低。对于由其他原因导致气管受压的儿童,手术时需格外谨慎。