DiTirro F R, Silver M H, Hengerer A S
Int J Pediatr Otorhinolaryngol. 1984 May;7(2):145-52. doi: 10.1016/s0165-5876(84)80038-5.
One hundred and forty-eight cases of acute epiglottitis in children treated at the University of Rochester's Strong Memorial Hospital and two affiliated community hospitals between 1965 and 1983 are reviewed retrospectively. Patients seen prior to 1975 were usually managed with tracheotomy and intravenous antibiotics, while those after 1975 with nasotracheal intubation, antibiotics and steroids. Tracheotomy and nasotracheal intubation were equally safe in controlling the upper airway. We compared our results with other series, primarily from children's hospitals, using nasotracheal intubation and found comparable results. Steroids provided no significant effect on the duration of intubation or infectious complications, but was associated with gastrointestinal bleeding. Long- and short-term complications of intubation, including self-extubation are discussed. We conclude that nasotracheal intubation is a safe method of management for acute epiglottitis in the community hospital.
回顾性分析了1965年至1983年间在罗切斯特大学斯特朗纪念医院及两家附属社区医院接受治疗的148例儿童急性会厌炎病例。1975年以前就诊的患者通常采用气管切开术和静脉注射抗生素治疗，而1975年以后的患者则采用鼻气管插管、抗生素和类固醇治疗。气管切开术和鼻气管插管在控制上呼吸道方面同样安全。我们将我们的结果与其他主要来自儿童医院的采用鼻气管插管的系列研究结果进行了比较，发现结果相当。类固醇对插管持续时间或感染并发症没有显著影响，但与胃肠道出血有关。讨论了插管的长期和短期并发症，包括自行拔管。我们得出结论，鼻气管插管是社区医院治疗儿童急性会厌炎的一种安全方法。
