Deng Kewei, Luo Liqian
Neonatal Department, Northwest Women and Children's Hospital, Xi'an City, Shaanxi Province 710061, China.
Evid Based Complement Alternat Med. 2022 Jul 13;2022:7264343. doi: 10.1155/2022/7264343. eCollection 2022.
The study aimed to analyse the detection rates of the triple-lumen double-balloon catheter technique and conventional esophagography in diagnosing H-type tracheoesophageal fistula (H-TEF) in neonates.
The data of 8 neonates diagnosed with H-TEF by surgery in the researchers' hospital between January 2015 and January 2022 were collected. We compared the detection (true positive) rates of H-TEF by the triple-lumen double-balloon catheter technique, conventional esophagography, and multidetector row spiral CT.
Before surgery, conventional esophagography was applied in all 8 cases, of which the H-TEF diagnosis was confirmed in 5 cases and TEF was suspected in 3 cases. The triple-lumen double-balloon catheter technique was employed in 5 cases, of which 4 were confirmed with H-TEF and 1 was suspected with TEF. Multidetector row spiral CT was performed in 4 cases, and 1 case was confirmed with H-TEF, while no fistula was observed in the other 3 cases. The triple-lumen double-balloon catheter technique yielded a 100% detection rate, while conventional esophagography revealed a 62.5% rate and multidetector row spiral CT showed a 25% rate. By comparative analysis, the true positive rates (TPRs) of the triple-lumen double-balloon catheter technique and conventional esophagography were not significantly different (=0.118). No significant differences were recorded in TPRs between conventional esophagography and multidetector row spiral CT (=0.221). However, the triple-lumen double-balloon catheter technique had a significantly higher TPR than multidetector row spiral CT (=0.118).
To diagnose congenital H-TEF in neonates, conventional esophagography is a highly valuable yet inconsistently reliable method and the diagnostic value of CT is relatively limited. The triple-lumen double-balloon catheter technique boasts a significantly valuable application for H-TEF diagnosis. Being simple, economical, and effective, it barely requires state-of-the-art facilities, and no complications have occurred during its clinical practice. These advantages justify a possible wider application of the triple-lumen double-balloon catheter technique in clinical practice.
本研究旨在分析三腔双气囊导管技术和传统食管造影在诊断新生儿H型气管食管瘘（H-TEF）中的检出率。
收集2015年1月至2022年1月在研究人员所在医院接受手术诊断为H-TEF的8例新生儿的数据。我们比较了三腔双气囊导管技术、传统食管造影和多排螺旋CT对H-TEF的检出（真阳性）率。
手术前，8例均采用传统食管造影，其中5例确诊为H-TEF，3例怀疑为TEF。5例采用三腔双气囊导管技术，其中4例确诊为H-TEF，1例怀疑为TEF。4例进行了多排螺旋CT检查，1例确诊为H-TEF，其他3例未观察到瘘管。三腔双气囊导管技术的检出率为100%，而传统食管造影的检出率为62.5%，多排螺旋CT的检出率为25%。通过比较分析，三腔双气囊导管技术和传统食管造影的真阳性率（TPR）无显著差异（=0.118）。传统食管造影和多排螺旋CT的TPR之间无显著差异（=0.221）。然而，三腔双气囊导管技术的TPR显著高于多排螺旋CT（=0.118）。
对于诊断新生儿先天性H-TEF，传统食管造影是一种非常有价值但可靠性不一致的方法，CT的诊断价值相对有限。三腔双气囊导管技术在H-TEF诊断中具有显著的应用价值。它简单、经济、有效，几乎不需要先进的设备，且在临床实践中未发生并发症。这些优点证明三腔双气囊导管技术在临床实践中可能有更广泛的应用。
