12例小儿急性上呼吸道梗阻的病因

目的：总结小儿急性上呼吸道梗阻的发生原因,以减少误诊率和病死率。方法：分析2007年3~12月该院儿科PICU住院的全部急性上呼吸道梗阻患儿(12例)的临床资料。全部病例均完成了胸部X线片、喉镜检查、喉部及肺部CT扫描及三维重建检查。结果：12例患儿院外诊断为先天性单纯性喉喘鸣（8例，67%）、急性喉炎等。入院后12例中4例(33%)经喉部CT扫描诊断为先天性甲状舌管囊肿, 1例(8%)为咽后壁脓气肿，1例(8%)为左颈部淋巴管瘤，2例(16%)为声门下狭窄，4例(33%)为急性喉炎。院外诊断与入院后诊断相比误诊率为67%。结论：小儿急性上呼吸道梗阻喉喘鸣非常容易误诊,尤其是婴幼儿，必须排除引起喉喘鸣的其他病理因素(如占位病变,先天性因素等)方可拟诊先天性单纯性喉喘鸣。甲状舌管囊肿是新生儿及婴幼儿喉喘鸣的常见原因之一，临床误诊率较高。因此，建议将喉镜检查作为新生儿及婴幼儿喉喘鸣的常规筛选手段,有条件者可进行喉部、肺CT扫描及三维重建检查。［中国当代儿科杂志，2009，11（2）：116-119］

Etiology of acute upper respiratory tract obstruction in infants: analysis of 12 cases

Objective To study the etiology of acute upper respiratory tract obstruction in infants.Methods The medical data of 12 infants with acute upper respiratory tract obstruction were retrospectively reviewed.The patients received the examinations of laryngoscopy and CT scans for larynx and lungs.Results All of the 12 infants presented with laryngeal stridor.Eight infants(67%)were diagnosed as congenital simple laryngeal stridor before admission.Based on the clinical features,laboratory examinations,imaging exam...