一例先天性气管狭窄合并喉气管食管裂的早产儿插管视频内镜：病例报告

文献信息

中文摘要

背景： 先天性喉气管食管裂与气管狭窄同时发生极为罕见。诊断困难，许多受累新生儿在数小时至数天内死亡。
病例介绍： 一名男性新生儿于妊娠32周5天时分娩。出生体重1364克。出生后不久即出现严重窒息和呼吸衰竭。气管内插管未成功，食管内插管未能提供有效通气。在持续面罩球囊通气的同时立即行软性插管视频内镜，识别出先天性喉气管食管裂和气管狭窄。考虑到该诊断、无法插管以及患者其他异常（包括左侧膈疝和先天性心脏病），提出姑息治疗，家属同意。他在出生后4小时死亡。
结论： 先天性喉气管食管裂和气管狭窄是一种罕见且多致死的异常，可在新生儿中通过插管视频内镜诊断。快速诊断有助于早期引入姑息治疗。

英文摘要

BACKGROUND: The co-occurrence of congenital laryngotracheoesophageal cleft and tracheal stenosis is extremely rare. Diagnosis is difficult and many affected neonates die within hours to days.
CASE PRESENTATION: A male neonate was delivered at 32 weeks and 5 days of gestation. Birth weight was 1364 g. Severe asphyxia and respiratory failure were apparent soon after birth. Endotracheal intubation was not successful and esophageal intubation did not provide effective ventilation. Flexible intubation videoendoscopy was performed immediately while continuing mask bagging, which identified congenital laryngotracheoesophageal cleft and tracheal stenosis. Considering the diagnosis, our inability to intubate, and the patient's other anomalies including left diaphragmatic hernia and congenital heart disease, palliative care was proposed and the family agreed. He died 4 h after birth.
CONCLUSIONS: Congenital laryngotracheoesophageal cleft and tracheal stenosis, a rare and mostly fatal anomaly, can be diagnosed in neonates using intubation videoendoscopy. Rapid diagnosis allows for the early introduction of palliative care.