321例儿童声门下狭窄的流行病学与手术结局：一项回顾性研究

文献信息

中文摘要

目的： 探讨儿童声门下狭窄（PSS）的流行病学、病因学及手术结局。
方法： 通过哈萨克斯坦共和国国家多中心数据库（数据集中保存于阿斯塔纳的Salidat Kairbekova国家健康发展科学中心）识别2019年至2024年在全国各地区机构接受治疗的321例PSS患儿，调取其病历，获取人口学、病因学及手术结局资料。
结果： 在已识别的520例PLS患者中，321例为PSS（女性133例）。2019年至2024年，女性/男性比例逐渐转变为男性占优势。确诊患者的平均年龄为4.38岁。大多数PSS病例为Myer-Cotton I级和II级。321例患者共实施383次手术操作（每例患者1.2次手术），主要包括球囊扩张联合经口CO2激光组织切除（n=191）、经口冷器械组织切除（n=89）以及不联合球囊扩张的经口CO2激光组织切除（n=64）。在39例气管切开患者中，14例（35.9%）术后成功拔管，另有61例在首次手术后立即拔管。平均住院时间为9.0±4.0天。
结论： 针对PSS的按分级定制的手术方法获得了良好的拔管率，经口手术对儿童低级别狭窄有效。

英文摘要

OBJECTIVES: To investigate epidemiological, etiological, and surgical outcomes of pediatric subglottic stenosis (PSS).
METHODS: Medical records of 321 children with PSS, identified through the national multicenter database of the Republic of Kazakhstan (data centralized at the Salidat Kairbekova National Scientific Center for Health Development, Astana) and treated at institutions across all regions of the country from 2019 to 2024, were retrieved for demographic, etiological, and surgical outcomes.
RESULTS: Of the 520 identified PLS patients, 321 had PSS (133 females). The female/male ratio progressively shifted to a predominance of males from 2019 to 2024. The mean age of diagnosed patients was 4.38 years. Most PSS cases were Myer-Cotton grades I and II. A total of 383 surgical procedures were carried out in the 321 patients (1.2 procedures per patient), primarily consisting of balloon dilatation with transoral CO2 laser tissue excision (n = 191), transoral cold instrument tissue resection (n = 89), and transoral CO2 laser tissue excision without balloon dilatation (n = 64). Of the 39 tracheostomized patients, 14 (35.9%) were adequately decannulated postoperatively, with 61 patients being decannulated immediately after the first procedure. The mean hospital stay was 9.0 ± 4.0 days.
CONCLUSIONS: Grade-tailored surgical approaches for PSS achieved favorable decannulation rates, with transoral procedures being effective for lower-grade stenoses in pediatric patients.