Hara Hirotaka, Hori Takeshi, Sugahara Kazuma, Ikeda Takuo, Kajimoto Madoka, Yamashita Hiroshi
Department of Otolaryngology, Yamaguchi University Graduate School of Medicine , Ube, Yamaguchi.
Acta Otolaryngol. 2014 Jun;134(6):626-30. doi: 10.3109/00016489.2014.885119. Epub 2014 Mar 19.
Laryngotracheal separation (LTS) can prevent aspiration pneumonia, improve the respiratory condition, and offer the possibility of home care for neurologically impaired children.
This study aimed to evaluate the effectiveness of LTS in neurologically impaired pediatric patients from the viewpoint of postoperative success of pneumonia prevention, improvement in the respiratory condition, and postoperative success rate of home-based care.
The medical records of 21 children who underwent LTS at an academic medical center from September 2004 to March 2013 were retrospectively investigated. Pre- and postoperative data, including the frequency of pneumonia treatment, the frequency of sputum suctioning, the respiratory condition, the nutrition method, and the outcome after LTS were assessed. We also used the scoring system for patients with severe motor and intellectual disabilities, medical care dependent group (SMID-MCDG) in Japan for evaluating the usefulness of LTS.
The frequency of pneumonia treatment and that of suctioning decreased considerably after LTS. Furthermore, the respiratory condition improved at a rate of 63.19%. The SMID-MCDG score significantly reduced after LTS. No significant complications were observed and two-thirds of the patients were successfully discharged for home care after the procedure.
喉气管分离术（LTS）可预防吸入性肺炎，改善呼吸状况，并为神经功能受损儿童提供居家护理的可能性。
本研究旨在从预防肺炎术后成功率、呼吸状况改善情况以及居家护理术后成功率的角度评估LTS在神经功能受损儿科患者中的有效性。
回顾性调查了2004年9月至2013年3月在一家学术医疗中心接受LTS的21名儿童的病历。评估术前和术后数据，包括肺炎治疗频率、吸痰频率、呼吸状况、营养方法以及LTS后的结果。我们还使用了日本重度运动和智力残疾、医疗护理依赖组（SMID-MCDG）患者的评分系统来评估LTS的有效性。
LTS后肺炎治疗频率和吸痰频率显著降低。此外，呼吸状况改善率为63.19%。LTS后SMID-MCDG评分显著降低。未观察到明显并发症，三分之二的患者术后成功出院接受居家护理。
