Benjamin B, O'Reilly B
Ann Otol Rhinol Laryngol. 1976 Sep-Oct;85(5 Pt.1):565-72. doi: 10.1177/000348947608500502.
Sixty-one cases of acute epiglottitis at the Royal Alexandra Hospital for Children, Sydney, from July 1968 to December 1974 are reviewed. The average age of 2.7 years is lower than previously reported. The average time from the initial symptom to arrival at the hospital was 14 hours. The average time from arrival to performance of tracheotomy was two hours. The diagnosis was made when first seen and assessed in 50 of the 61 cases. There were eight respiratory arrests in the Casualty and five of these were successfully resuscitated. We believe that an artificial airway is necessary in most cases, and in this series, tracheotomy was performed, with minimal complications. Particular emphasis is given to diagnosis from the history, and a detailed description is given of physical examination of the oropharynx. Although x-ray examination is usually unnecessary when the diagnosis is in doubt, a plain lateral x-ray may be useful, with due precaution not to increase the respiratory obstruction. We consider that a patient with acute epiglottitis should be transferred immediately to a major pediatric hospital, and that in almost every case an artificial airway should be established.
对1968年7月至1974年12月期间悉尼皇家亚历山德拉儿童医院收治的61例急性会厌炎病例进行了回顾性研究。平均年龄2.7岁，低于此前报道。从出现初始症状到入院的平均时间为14小时。从入院到行气管切开术的平均时间为2小时。61例中有50例在首次就诊并评估时即做出诊断。急诊室有8例呼吸骤停，其中5例成功复苏。我们认为大多数情况下需要建立人工气道，在本系列研究中，实施了气管切开术，并发症极少。特别强调根据病史进行诊断，并对口咽部体格检查进行了详细描述。虽然诊断存疑时通常无需进行X线检查，但谨慎操作以避免加重呼吸道梗阻的情况下，普通侧位X线检查可能有用。我们认为急性会厌炎患者应立即转至大型儿科医院，且几乎在每种情况下都应建立人工气道。
