儿童吸气性喉喘鸣的病因分析

目的 探讨儿童吸气性喉喘鸣的发生原因,提高儿童吸气性喉喘鸣的诊治率.方法 回顾性分析2005年1月至2007年1月深圳市儿童医院住院的吸气性喉喘鸣患儿共378例,男245例,女133例;年龄12 h～30个月,中位年龄4个月.全部病例均行胸部X线摄片检查,218例进行了胸部CT扫描、电子喉镜、直接喉镜、纤维支气管镜等检查.结果 急性喉炎140例,喉软化117例,急性喉气管支气管炎54例,声带麻痹18例,先天性气管软化9例,先天性喉蹼8例,先天性喉裂6例,喉囊肿6例,喉乳头状瘤6例,急性会厌炎4例,先天性声门下狭窄3例,气管支气管异物3例,甲状舌管囊肿1例.除先天性气管软化9例,先天性喉裂6例,先天性声门下狭窄3例,声带麻痹18例,仅给予对症治疗外,复发性喉乳头状瘤尚在治疗中,其他病例均获痊愈.结论 儿童吸气性喉喘鸣病因复杂,以急性喉炎和喉软化最为多见.由炎症引起的喉喘鸣经保守治疗可获痊愈,电子喉镜检查是喉喘鸣患儿必要的检查手段,有时需配合胸部CT和纤维支气管镜检查.

Etiology of inspiratory laryngeal stridor in children

Objective Retrospective analysis was performed on the etiology of inspiratory laryngeal stridor in children. The purpose is to raise the diagnosis and cure rate of the disease. Methods All patients were hospitalized in Children's Hospital from Jan, 2005 to Jan, 2007. Among of them, 245 cases were male and 133 cases were female. The median age was 4 months (range from 12 hours to 30 months). All the patients had chest X-ray examination. Two hundred and eighteen cases received chest CT scan, video laryngoscope, direct laryngoscope and bronchofibroscope. Results The diagnosis were as fallows: acute laryngitis (140 cases), laryngomalacia (117 cases), acute laryngotracheal bronchitis (54 cases), vocal cord paralysis (18 cases), congenital tracheomalacia(9 cases), cangenital laryngeal webs (8 cases), congenital cleft of larynx (6 cases), laryngeal cyst(6 cases), laryngeal papilloma (6 cases), acute epiglottitis (4 cases), congenital infraglottic stenosis (3 cases), tracheobronchial foreign body (3 cases), cystis thyrolingualis(1 cases). All cases were cured except congenital tracheomalacia(9 cases), congenital cleft of larynx(6 cases), laryngeal papilloma(6 cases), congenital infraglottic(3 cases). Conclusions The etiology of inspiratory laryngeal stridor in children are very complicated. Video laryngoscope is recommended for all cases except for the acute inflammation disease. Chest CT scan and bronchofibrescope may be necessary for some cases.