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马来西亚一家三级医院小儿喘鸣的病因概况

Aetiological profile of paediatric stridor in a Malaysian tertiary hospital.

作者信息

Lum S G, Noor Liza I, Priatharisiny V, Saraiza A B, Goh B S

机构信息

MD (UKM), MS ORL-HNS (UKM) Department of Otorhinolaryngology, Hospital Serdang, Jalan Puchong, 43000 Kajang, Selangor, Malaysia Email:

MB BCH BAO (NUI), MS ORL-HNS (UKM) Otorhinolaryngology and Head and Neck surgery Unit, Universiti Putra Malaysia, Selangor, Malaysia.

出版信息

Malays Fam Physician. 2016 Apr 30;11(1):2-6. eCollection 2016.

Abstract

BACKGROUND

Conditions causing stridor in paediatric patients can range from minor illnesses to life-threatening disorders. Proper evaluation and correct diagnosis are essential for timely intervention. The objective of this study was to determine the aetiological profiles and the management of paediatric patients with stridor referred to the Otorhinolaryngology Department of Hospital Serdang.

METHODS

Medical records of all paediatric patients presenting with symptom of stridor from January 2010 to February 2015 were reviewed retrospectively. The patients' demographic data, clinical notes, laryngoscope findings, diagnosis and management were retrieved and analysed.

RESULTS

Out of the total 137 patients referred for noisy breathing, 121 patients had stridor and were included in this study. There were 73 males and 48 females-most were of Malay ethnicity (77.7%). The age of presentation ranged from newborn to 10 years, with a mean of 4.9 months. Eighteen patients (14.9%) had associated congenital pathologies. The majority were congenital causes (90.9%), in which laryngomalacia was the commonest (78.5%), followed by subglottic stenosis (5.0%), vallecular cyst (2.5%) and congenital vocal fold paralysis (2.5%). Twelve patients (9.9%) had synchronous airway lesion. The majority of the patients were managed conservatively. Thirty-one patients (25.6%) required surgical intervention, of which only one needed tracheostomy.

CONCLUSION

Laryngomalacia was the commonest cause of stridor among paediatric patients. A synchronous airway lesion should be considered if the child has persistent or severe symptoms. The majority of the patients were managed conservatively.

摘要

背景

导致小儿喘鸣的病症范围可从小病到危及生命的疾病。正确评估和准确诊断对于及时干预至关重要。本研究的目的是确定转诊至沙登医院耳鼻喉科的小儿喘鸣患者的病因谱及治疗情况。

方法

回顾性分析2010年1月至2015年2月所有出现喘鸣症状的小儿患者的病历。收集并分析患者的人口统计学数据、临床记录、喉镜检查结果、诊断和治疗情况。

结果

在总共137例因呼吸嘈杂而转诊的患者中,121例有喘鸣症状并纳入本研究。其中男性73例,女性48例,大多数为马来族(77.7%)。就诊年龄从新生儿到10岁不等,平均为4.9个月。18例患者(14.9%)伴有先天性疾病。大多数为先天性病因(90.9%),其中喉软化最常见(78.5%),其次是声门下狭窄(5.0%)、会厌囊肿(2.5%)和先天性声带麻痹(2.5%)。12例患者(9.9%)有同步气道病变。大多数患者采用保守治疗。31例患者(25.6%)需要手术干预,其中只有1例需要气管切开术。

结论

喉软化是小儿喘鸣最常见的原因。如果儿童有持续或严重症状,应考虑同步气道病变。大多数患者采用保守治疗。

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