Parkin J L, Stevens M H, Jung A L
Ann Otol Rhinol Laryngol. 1976 Sep-Oct;85(5 Pt.1):573-81. doi: 10.1177/000348947608500503.
During the calendar year of 1974, the Intermountain Newborn Intensive Care Center at the University of Utah Medical Center had 603 admissions. A representative group of 293 charts were reviewed which indicated that 44% of these children were intubated from hours to weeks. The overall mortality rate for the 293 children was 29%. Eighteen of the 603 children were diagnosed as having subglottic stenosis. Fifteen of these children appeared to have acquired subglottic stenosis secondary to endotracheal intubation. Three children had congenital subglottic stenosis. Tracheostomy was necessary in the management of 15 patients. Ten of the 18 patients have survived and two of these patients still have tracheostomy tubes in place. The survival and thickness of the stenotic area are inversely proportional to the birth weight and the duration of intubation. Endoscopic excision, dilatation and stenting were techniques utilized in the treatment of these stenotic lesions. The extubation technique utilized is described. The factors involved in the production of acquired subglottic stenosis are presented along with suggestions to decrease the incidence of this problem in the intubated child.
在1974年日历年期间，犹他大学医学中心的山间新生儿重症监护中心收治了603名患儿。对一组具有代表性的293份病历进行了回顾，结果显示其中44%的患儿接受了从数小时至数周的气管插管。这293名患儿的总体死亡率为29%。603名患儿中有18名被诊断为声门下狭窄。其中15名患儿似乎是继发于气管插管而获得性声门下狭窄。3名患儿患有先天性声门下狭窄。15例患者的治疗需要气管造口术。18例患者中有10例存活，其中2例仍留置气管造口管。狭窄区域的存活情况和厚度与出生体重及插管持续时间成反比。内镜切除、扩张和支架置入是用于治疗这些狭窄病变的技术。描述了所采用的拔管技术。介绍了获得性声门下狭窄发生的相关因素，并提出了降低插管患儿出现此问题发生率的建议。
