Ungkanont K, Friedman E M, Sulek M
Department of Otolaryngology, Siriraj Hospital, Bangkok, Thailand.
Laryngoscope. 1998 Nov;108(11 Pt 1):1724-8. doi: 10.1097/00005537-199811000-00024.
To review the authors' experience with neonates who underwent endoscopy over an 8-year period.
Retrospective review in a tertiary care children's hospital.
Sixty-two neonates who underwent endoscopy were reviewed.
Common indications for endoscopy were stridor (56%), apnea/cyanotic episodes (30%), and feeding difficulty (23%). Laryngeal abnormalities were the most frequent finding, including laryngomalacia (19%), glottic edema (19%), and vocal cord paralysis (13%). Pierre Robin sequence was the most common associated anomaly. Forty-eight neonates (77.4%) had more than one endoscopic finding. Gastroesophageal reflux diagnosed by barium swallow or esophageal pH monitoring was found in 34%. Gastroesophageal reflux was the only identified etiologic factor in four cases. Computed tomography and magnetic resonance imaging provided less information than endoscopy.
Endoscopy in symptomatic neonates can determine etiology of distress most of the time. Multiple diagnoses were found in 77.4% of the neonates, emphasizing the need for a thorough aerodigestive tract examination. Concomitant diagnoses including gastroesophageal reflux, congenital heart disease, and pulmonary disease were found in 87.1% of neonates. Neonates have a higher likelihood of having multiple lesions in the aerodigestive tract as compared with older infants or children.
回顾作者在8年期间对接受内镜检查的新生儿的经验。
在一家三级儿童专科医院进行回顾性研究。
对62例接受内镜检查的新生儿进行回顾。
内镜检查的常见指征为喘鸣（56%）、呼吸暂停/发绀发作（30%）和喂养困难（23%）。喉部异常是最常见的发现，包括喉软化（19%）、声门水肿（19%）和声带麻痹（13%）。皮埃尔·罗宾序列是最常见的相关异常。48例新生儿（77.4%）有不止一项内镜检查发现。通过钡餐或食管pH监测诊断出胃食管反流的占34%。胃食管反流是4例中唯一确定的病因。计算机断层扫描和磁共振成像提供的信息比内镜检查少。
有症状新生儿的内镜检查大多时候能确定窘迫的病因。77.4%的新生儿有多种诊断结果，强调了对上呼吸道和消化道进行全面检查的必要性。87.1%的新生儿同时存在胃食管反流、先天性心脏病和肺部疾病等诊断结果。与大龄婴儿或儿童相比，新生儿上呼吸道和消化道出现多种病变的可能性更高。
