心胸外科手术后声带运动障碍患者的肠内喂养方法
Enteral Feeding Methods in Patients with Vocal Fold Motion Impairment Following Cardiothoracic Surgery.
文献信息
| PMID | 42730767 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Amber Molin |
| 作者单位 | Capital District Pediatric Cardiology Associates, Albany, NY, 12208, USA. Ambermolin22@gmail.com. |
| 期刊 | Pediatric cardiology |
| SCI 分区 | Q3 |
| IF | 1.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
先天性心脏病患儿的声带运动障碍发生于心胸外科手术中主动脉弓操作时，由于喉返神经损伤所致。我们开展了一项单中心回顾性分析，纳入2021年至2023年间心胸外科手术后诊断为声带运动障碍的儿科患者（≤18岁）。患者按是否存在声带运动障碍进行分类，然后细分为幽门前或幽门后肠内喂养组。在61例符合纳入标准的患者中，32例被诊断为声带运动障碍。患有声带运动障碍的婴儿住院时间更长（35 [18, 199.5] 天 vs 22 [9, 39] 天，p = 0.03），手术更复杂/主动脉弓扩大术更多（75% vs 41%，p = 0.02），并且更多通过鼻十二指肠途径喂养（31% vs 7%，p = 0.02）。与幽门前途径喂养的患者相比，通过鼻十二指肠途径喂养的患者更可能具有更长的体外循环时间（188 [147, 251] 分钟 vs 93 [76, 100] 分钟，p = 0.01）、单心室姑息治疗（60% vs 18%，p = 0.037）和更长的住院时间（138 [44, 255] 天 vs 24.5 [16, 60] 天，p = 0.02）。两组之间在误吸事件（p = 0.09）、吸入性肺炎（p = 1.0）或再入院率（30天内，p = 0.22）方面没有差异。声带运动障碍患者的幽门前喂养方法在术后并未出现更多误吸不良事件。
英文摘要
Vocal fold motion impairment in children with congenital heart disease occurs at the time of cardiothoracic, surgical aortic arch manipulation due to injury of the recurrent laryngeal nerve. We conducted a single-center retrospective analysis of pediatric patients (≤ 18 years old) diagnosed with vocal fold motion impairment post-cardiothoracic surgery between 2021 and 2023. Patients were categorized by the presence or absence of vocal fold motion impairment and then subdivided into pre- or post-pyloric enteral feed groups. Of the 61 patients eligible for inclusion, 32 were diagnosed with vocal fold motion impairment. Infants with vocal fold motion impairment had a longer length of stay (35 [18, 199.5] versus 22 [9, 39] days, p = 0.03), more complex surgeries/aortic arch augmentation (75% versus 41%, p = 0.02), and were fed more by nasoduodenal route (31% versus 7%, p = 0.02). Patients who were fed via the nasoduodenal route compared to those fed via the pre-pyloric route were more likely to have longer cardiopulmonary bypass times (188 [147, 251] versus 93 [76, 100] min, p = 0.01), single ventricle palliation (60% versus 18%, p = 0.037) and longer length of stay (138 [44, 255] versus 24.5 [16, 60] days, p = 0.02). There was no difference in aspiration events (p = 0.09), aspiration pneumonia (p = 1.0), or readmission rates (within 30 days, p = 0.22) between the groups. Pre-pyloric feeding methods in patients with vocal fold motion impairment had no more adverse events of aspiration post-operatively.