Kazim R, Quaegebeur J M, Sun L S
Department of Anesthesiology, Columbia University, College of Physicians and Surgeons, New York, NY, USA.
J Cardiothorac Vasc Anesth. 1996 Aug;10(5):589-92. doi: 10.1016/s1053-0770(96)80134-0.
To determine the incidence of tracheal anomalies in children with tetralogy of Fallot.
Retrospective.
A university children's hospital.
Forty-four children with the diagnosis of tetralogy of Fallot who underwent either primary or palliative cardiac surgery.
Three criteria were used to identify tracheal abnormalities: (1) direct laryngoscopic evidence; (2) radiographic evidence; and/or (3) inability to intubate the trachea with an endotracheal (ET) tube of appropriate size for age, followed by insertion of a 2.5-mm ET tube. An 11% incidence (5/44) of tracheal anomalies was noted. These could be separated into two categories: isolated upper airway pathology (either glottic or subglottic stenosis) and lower tracheal pathology. None of the five children identified with tracheal abnormalities manifested any preoperative signs or symptoms suggestive of airway problems. Four of the children experienced significant perioperative complications resulting directly from the underlying tracheal pathology. This represented a 9% morbidity (4/44) for patients presenting for repair of tetralogy of Fallot.
A significant incidence of tracheal anomalies is associated with tetralogy of Fallot, leading to potential perioperative complications.
确定法洛四联症患儿气管异常的发生率。
回顾性研究。
一家大学儿童医院。
44例诊断为法洛四联症并接受一期或姑息性心脏手术的患儿。
采用三项标准来识别气管异常：（1）直接喉镜检查证据；（2）影像学证据；和/或（3）无法用适合患儿年龄的气管内（ET）导管插入气管，随后插入一根2.5毫米的ET导管。气管异常的发生率为11%（5/44）。这些异常可分为两类：孤立的上气道病变（声门或声门下狭窄）和下气管病变。确诊有气管异常的5名患儿术前均未表现出任何提示气道问题的体征或症状。4名患儿出现了直接由潜在气管病变导致的严重围手术期并发症。对于前来接受法洛四联症修复手术的患者，这代表了9%的发病率（4/44）。
法洛四联症患儿气管异常的发生率较高，可导致潜在的围手术期并发症。
