儿童先天性心脏病合并气管狭窄的诊治

目的探讨儿童先天性心脏病合并气管狭窄的诊治。方法对13例先天性心脏病合并气管狭窄的患儿，进行胸部CT气道三维重建、气管内造影和纤维支气管镜检查。在10例先心根治术中，3例未处理气管狭窄，3例行气管切开，4例行气管成形术。结景胸部CT气道三维重建和纤维支气管镜，能较为安全地明确气管狭窄的位置、范围。3例气管切开患儿需要长期带管生存；4例气管成形术患儿有2例获得良好手术效果。结论胸部CT气道三维重建和纤维支气管镜技术相结合，对于气管狭窄的诊断具有较大的价值。根治先天性心脏病合并气管狭窄，以一期手术治疗为好。

Approaches of Diagnosis and Treatment of Children Congenital Heart Diseases with Tracheal Stenosis

Objective To discuss the approaches of diagnosis and treatment of children congenital heart diseases (CHD) with tracheal stenosis. Methods Thirteen children with tracheal stenosis associated with CHD were exa- mined through chest CT scanning of three-dimensional airway reconstruction, bronchograph and bronchofiberoscope inspection.Amony 10 children undergoing radical heart surgery, 3 were synchronously treated by trachea incision, and 4 by tracheoplastic procedures. Results For confirming the location and range of tracheal stenosis, chest CT scanning of three-dimensional airway reconstruction and bronchofiberoscope inspection was relatively safe and effective. Three children with trachea incision, required catheter for a long time. Two of the children with tracheoplastic procedures achieved a fine therapeutic outcome. Conclusion CT imaging of three-dimensional airway reconstruction combined with bronchofiberoscope inspection is very useful for diagnosis and differential diagnosis of tracheal stenosis. One stage operation can achieve better outcome for tracheal stenosis children associated with CHD compared with other therapeutic strategies.