10岁儿童气管插管后严重声门下狭窄1例

Venus Chegini, Victoria Chegini, M. Esfahani, H. Moeini
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引用次数: 0

摘要

背景:声门下狭窄是儿童最常见的气道问题之一,即获得性或先天性。超过90%的获得性病例继发于气管插管,并发生医源性。声门下狭窄是一个意想不到的问题,需要及时诊断和干预。大多数儿童声门下狭窄的病例是轻度到中度的。病例介绍:患者是一名10岁儿童,早出院后因头部外伤长时间插管,当天因高热和呼吸短促被转至儿童医院。随着呼吸窘迫和紫绀的发展,患者被转移到重症监护室。由于患者年龄不可能通过气管管,初步诊断为声门下狭窄,并行气管切开术。诊断性支气管镜检查证实严重的声门下狭窄,儿童被转介到专门的耳鼻喉(ENT)中心修复气管狭窄。结论:儿童喘鸣最常见的原因之一是长时间插管后的声门下狭窄。认识易感因素,预防,临床强烈怀疑,及时诊断和治疗,可防止儿童进一步发生不良并发症或后果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A 10-year-old Child with Severe Subglottic Stenosis Following Intubation: A Case Report
Background: Subglottic stenosis is among the most common airway problems in children, i.e., acquired or congenital. More than 90% of acquired cases are secondary to endotracheal intubation and occur iatrogenically. Subglottic stenosis is an unexpected problem that requires timely diagnosis and intervention. Most cases of subglottic stenosis in children are mild to moderate. Case Presentation: The presented patient was a 10-year-old child who, after long intubation due to head trauma following early discharge from the surgical center, was referred to the Children’s Hospital on the same day with a complaint of high fever and shortness of breath. With the development of respiratory distress and cyanosis, the patient was transferred to the intensive care unit. Due to the impossibility of passing the tracheal tube with the appropriate age for the patient, the initial diagnosis of subglottic stenosis was established and a tracheostomy was performed. Diagnostic bronchoscopy confirmed severe subglottic stenosis, and the child was referred to a specialized Ear, Nose, Throat (ENT) center for the repair of the tracheal stenosis. Conclusion: One of the most common causes of stridor in children is subglottic stenosis following prolonged intubation. Recognizing the predisposing factors, prevention, strong clinical suspicion, timely diagnosis, and treatment can prevent further adverse complications or consequences in children.
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