Beasley S W, Shann F A, Myers N A, Auldist A W
Royal Children's Hospital, Parkville, VIC.
Med J Aust. 1989 May 1;150(9):501-3. doi: 10.5694/j.1326-5377.1989.tb136595.x.
Since 1948, when the first patient with oesophageal atresia and a tracheo-oesophageal fistula was treated successfully at the Royal Children's Hospital, Melbourne, 569 infants with one or both conditions have been managed at that institution. The mortality rate in those in whom surgical repair of the oesophageal atresia and distal tracheo-oesophageal fistula was attempted has declined from 55% in the first 10 years to less than 1% in the last 10 years of the series. Earlier diagnosis and improvements in resuscitation, transport, neonatal intensive care, anaesthesia, the treatment of associated anomalies and surgical technique all are likely to have contributed to the decline in the mortality and morbidity rates. Problems which remain unresolved in part relate to the aetiology and embryogenesis of oesophageal atresia, the management of long-gap atresia, and the treatment of gastro-oesophageal reflux and tracheomalacia. This article outlines the improvements in management which have occurred already and speculates about what the future may hold.
自1948年墨尔本皇家儿童医院成功治疗首例食管闭锁合并气管食管瘘患儿以来，该机构已收治569例患有其中一种或两种病症的婴儿。尝试对食管闭锁和远端气管食管瘘进行手术修复的患儿死亡率，已从该系列的前10年中的55%降至最后10年的不到1%。早期诊断以及复苏、转运、新生儿重症监护、麻醉、相关畸形的治疗和手术技术的改进，都可能促使了死亡率和发病率的下降。部分仍未解决的问题与食管闭锁的病因和胚胎发生、长段间隙性闭锁的处理以及胃食管反流和气管软化的治疗有关。本文概述了已取得的管理改进，并对未来情况进行了推测。
