Lung Transplantation Research Center (LTRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tracheal Diseases Research Center (TDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Gen Thorac Cardiovasc Surg. 2022 Jun;70(6):553-558. doi: 10.1007/s11748-021-01767-2. Epub 2022 Jan 8.
Post-intubation tracheal stenosis (PITS) is an iatrogenic injury that involves some patients. Given the importance of this issue and the referral of a significant number of children with tracheal stenosis to Masih Daneshvari Hospital in Tehran, Iran, the present study investigated tracheal stenosis following prolonged intubation in the pediatric age group.
In this observational retrospective study, from 1994 to 2018, the medical records of all children under 14 years of age with a history of PITS were reviewed. Demographic and clinical characteristics including signs and symptoms, the underlying condition that leads to intubation, duration of intubation, type of stenosis, and the therapeutic approach, type of surgery, and follow-up were collected and analyzed using SPSS.
Among 161 patients with a mean age of 9.8 ± 4.2 years, 69% were male. The site of stenosis was limited to the trachea in 47% and others both trachea and subglottic area were involved. The most common cause of intubation was trauma. The most common symptoms were dyspnea and wheezing. Success rates of reconstruction were 93.75% in type I, 82.15% in type II, and 35.70% in type III. Among the 16 patients who underwent Type III surgery, decannulation was not performed in 11 patients. Traction in the anastomosis and complications were stated in 26 and 10% of the patients respectively, a mortality rate of 8.7% was also reported.
In the case of endotracheal intubation, PITS should be considered in the differential diagnosis of dyspnea in children as well as adults.
气管插管后狭窄（PITS）是一种医源性损伤，部分患者会出现这种损伤。鉴于这一问题的重要性，以及大量气管狭窄患儿转诊至伊朗德黑兰 Masih Daneshvari 医院，本研究调查了小儿长时间气管插管后的气管狭窄。
在这项回顾性观察研究中，回顾了 1994 年至 2018 年期间所有有 PITS 病史且年龄在 14 岁以下的儿童的病历。收集并使用 SPSS 分析了人口统计学和临床特征，包括体征和症状、导致插管的基础疾病、插管时间、狭窄类型以及治疗方法、手术类型和随访情况。
在 161 例平均年龄为 9.8±4.2 岁的患者中，69%为男性。狭窄部位局限于气管的占 47%，其余的同时累及气管和会厌下区域。插管最常见的原因是创伤。最常见的症状是呼吸困难和喘息。I 型重建成功率为 93.75%，II 型为 82.15%，III 型为 35.70%。在接受 III 型手术的 16 例患者中，11 例未进行拔管。吻合口牵引和并发症分别在 26%和 10%的患者中出现，死亡率为 8.7%。
在进行气管插管时，儿童呼吸困难的鉴别诊断应考虑到 PITS。
