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巴西儿童非囊性纤维化支气管扩张症的外科治疗

Surgical treatment of non-cystic fibrosis bronchiectasis in Brazilian children.

作者信息

Andrade Cristiano Feijó, Melo Iury Andrade, Holand Arthur Rodrigo Ronconi, Silva Éverton Franco, Fischer Gilberto Bueno, Felicetii José Carlos

机构信息

Postgraduate Program in Pulmonary Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil,

出版信息

Pediatr Surg Int. 2014 Jan;30(1):63-9. doi: 10.1007/s00383-013-3420-7. Epub 2013 Oct 9.

DOI:10.1007/s00383-013-3420-7
PMID:24105331
Abstract

PURPOSE

To determine the clinical characteristics of patients submitted to surgical treatment for non-cystic fibrosis (CF) bronchiectasis, the indications for surgery, and the results obtained at a referral facility for pediatric thoracic surgery.

METHODS

Between January 1998 and December 2009, we retrospectively reviewed the medical charts of 109 pediatric patients with non-CF bronchiectasis who underwent surgical treatment. These findings were subsequently analyzed by focusing on postoperative complications and long-term results.

RESULTS

Of the 109 patients undergoing pulmonary resection, the mean age was 7.6 years (ranging from 1 to 15.5 y-o) with male predominance (59 %). The most common procedure was segmentectomy (43 %) followed by left lower lobectomy (38 %). Minor postoperative complications occurred in 36 % of the patients; the most common was transient atelectasis (26 %), followed by air leak (6 %), and postoperative pain (4 %). There was one death within the 30-day postoperative period, but it was unrelated to the procedure. Eighty-three children were followed after discharge, with a mean follow-up period of 667 days. Sixty-five (76 %) patients showed improvement of clinical symptoms after surgery.

CONCLUSIONS

Lung resection for the treatment of non-CF bronchiectasis in children is a safe procedure, with no life-treating morbidity and low mortality. This procedure also leads to significant improvements in symptoms and quality of life.

摘要

目的

确定因非囊性纤维化(CF)支气管扩张接受手术治疗的患者的临床特征、手术指征以及在一家小儿胸外科转诊机构所取得的治疗结果。

方法

在1998年1月至2009年12月期间,我们回顾性分析了109例接受手术治疗的非CF支气管扩张患儿的病历。随后,通过关注术后并发症和长期治疗结果对这些发现进行分析。

结果

在109例接受肺切除术的患者中,平均年龄为7.6岁(范围为1至15.5岁),男性居多(59%)。最常见的手术方式是肺段切除术(43%),其次是左下肺叶切除术(38%)。36%的患者出现了轻微术后并发症;最常见的是短暂性肺不张(26%),其次是气胸(6%)和术后疼痛(4%)。术后30天内有1例死亡,但与手术无关。83名患儿出院后接受了随访,平均随访期为667天。65例(76%)患者术后临床症状有所改善。

结论

儿童非CF支气管扩张的肺切除术是一种安全的手术,没有危及生命的并发症且死亡率低。该手术还能显著改善症状和生活质量。

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Early respiratory therapy reduces postoperative atelectasis in children undergoing lung resection.早期呼吸治疗可减少儿童肺切除术后肺不张。
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Post infectious bronchiolitis obliterans in children.儿童感染后细支气管炎闭塞
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