内镜下球囊扩张治疗儿童声门下狭窄

摘要

目的 探讨内镜下球囊扩张技术治疗声门下狭窄的有效性.方法 回顾性分析2013年10月至2015年4月用该方法治疗的9例儿童声门下狭窄患者临床资料.男8例,女1例.年龄7个月至7岁,平均年龄2.5岁.狭窄程度按Myer-Cotton法分类:Ⅱ°7例,Ⅲ°2例.病因为气管插管辅助呼吸后引起者8例,切割伤1例.结果 患者行球囊扩张手术1～3次,平均1.8次.成功拔管6例(66.7％),其中一次扩张治疗即拔管者4例(44.4％).2例患者术后出现气胸.结论 对于程度较轻的声门下狭窄,内镜下球囊扩张是一种相对安全有效和微创的手术方法.%Objective To evaluate the efficacy of endoscopic balloon dilation for subglottic stenosis.Methods The clinical outcomes of 9 pediatric patients treated with balloon dilation were retrospectively analyzed.There were 8 male and Ⅰ female.Their age ranged from 7 months to 7 years (mean 2.5 years).The degree of stenosis was classified according to Myer-Cotton classification as follows:grade Ⅱ (n =7) and grade Ⅲ (n =2).The causes of the stenosis were postintubation lesions (n =8) and laryngeal penetrating trauma (n =1).Results The patients had undergone 1 to 3 dilations with an average of 1.8 procedures per patient.Six (66.7％) patients were decannulated.Among them,4 (44.4％) were decannulated after one dilation procedure.Pneumothoraces occurred in 2 children postoperatively.Conclusion Endoscopic balloon dilation is an effective,relatively safe and minimally invasive surgical method for patients with low-grade subglottic stenosis.