中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2011年
4期
275-278
,共4页
声嘶%婴儿%喉镜检查
聲嘶%嬰兒%喉鏡檢查
성시%영인%후경검사
Hoarseness%Infant%Laryngoscopy
目的 探讨婴儿持续声嘶的病因.方法 回顾性分析2008年6月至2010年7月间因持续声嘶就诊的婴儿117例(所有患儿均经2周抗炎治疗后声嘶无好转).按初诊年龄分为3组:新生儿组22例,小于6个月龄组60例,小于12个月龄组35例.所有患儿均接受电子喉镜检查,部分患儿行CT、心脏彩超、病理检查,并结合病史分析病因.结果 117例患儿中声带肥厚增生45例次(37.81%),声带麻痹39例次(32.78%),喉血管瘤7例次(5.89%),喉蹼喉囊肿4例次(3.36%),声带息肉2例次(1.68%),声门闭合不全2例次(1.68%),喉乳头状瘤、声带肉芽增生(气管插管后)、颈部淋巴管瘤压迫声门各1例次(各占0.84%);喉镜检查发现占位性病变但未进一步检查确诊者4例,喉镜检查没有发现异常13例.39例声带麻痹患儿伴发先天性心脏病者共19例,占48.72%.年龄越小声带麻痹患儿比率越高,其中新生儿组达50.00%,小于6个月龄组36.67%,小于12个月龄组17.14%,差异有统计学意义(x2=7.18,P＜0.05).结论 引起婴儿持续声嘶的病因以声带肥厚增生最多见,其次为声带麻痹.声带麻痹在小龄婴儿中较大龄婴儿更常见,以先天性心脏病术后及先天性心脏病为主要原因.
目的 探討嬰兒持續聲嘶的病因.方法 迴顧性分析2008年6月至2010年7月間因持續聲嘶就診的嬰兒117例(所有患兒均經2週抗炎治療後聲嘶無好轉).按初診年齡分為3組:新生兒組22例,小于6箇月齡組60例,小于12箇月齡組35例.所有患兒均接受電子喉鏡檢查,部分患兒行CT、心髒綵超、病理檢查,併結閤病史分析病因.結果 117例患兒中聲帶肥厚增生45例次(37.81%),聲帶痳痺39例次(32.78%),喉血管瘤7例次(5.89%),喉蹼喉囊腫4例次(3.36%),聲帶息肉2例次(1.68%),聲門閉閤不全2例次(1.68%),喉乳頭狀瘤、聲帶肉芽增生(氣管插管後)、頸部淋巴管瘤壓迫聲門各1例次(各佔0.84%);喉鏡檢查髮現佔位性病變但未進一步檢查確診者4例,喉鏡檢查沒有髮現異常13例.39例聲帶痳痺患兒伴髮先天性心髒病者共19例,佔48.72%.年齡越小聲帶痳痺患兒比率越高,其中新生兒組達50.00%,小于6箇月齡組36.67%,小于12箇月齡組17.14%,差異有統計學意義(x2=7.18,P＜0.05).結論 引起嬰兒持續聲嘶的病因以聲帶肥厚增生最多見,其次為聲帶痳痺.聲帶痳痺在小齡嬰兒中較大齡嬰兒更常見,以先天性心髒病術後及先天性心髒病為主要原因.
목적 탐토영인지속성시적병인.방법 회고성분석2008년6월지2010년7월간인지속성시취진적영인117례(소유환인균경2주항염치료후성시무호전).안초진년령분위3조:신생인조22례,소우6개월령조60례,소우12개월령조35례.소유환인균접수전자후경검사,부분환인행CT、심장채초、병리검사,병결합병사분석병인.결과 117례환인중성대비후증생45례차(37.81%),성대마비39례차(32.78%),후혈관류7례차(5.89%),후복후낭종4례차(3.36%),성대식육2례차(1.68%),성문폐합불전2례차(1.68%),후유두상류、성대육아증생(기관삽관후)、경부림파관류압박성문각1례차(각점0.84%);후경검사발현점위성병변단미진일보검사학진자4례,후경검사몰유발현이상13례.39례성대마비환인반발선천성심장병자공19례,점48.72%.년령월소성대마비환인비솔월고,기중신생인조체50.00%,소우6개월령조36.67%,소우12개월령조17.14%,차이유통계학의의(x2=7.18,P＜0.05).결론 인기영인지속성시적병인이성대비후증생최다견,기차위성대마비.성대마비재소령영인중교대령영인경상견,이선천성심장병술후급선천성심장병위주요원인.
Objective To explore the causes of persistent hoarseness in infants. Methods One hundred and seventeen infants with persistent hoarseness treated in the department of otorhinolaryngology in Children's Hospital of Fudan University between June 2008 and July 2010 were retrospectively analyzed ( all patients received antibiotic therapy for 2 weeks and the symptoms were not relieved after that). The patients were divided into three groups according to the age at first visit: 22 newborns, ＜ 6 months old in 60 cases,＜ 12 months old in 35 cases. All patients had video laryngoscope examinations. Some of them received CT scan, cardiac ultrasonography and pathological examination in additional. The diagnosis was established by clinical history and imaging modalities, and the causes were analyzed subsequently. Results Among the 117 patients, 45 cases were vocal hypertrophy and hyperplasia (37. 81% ), 39 cases were vocal cord paralyses (32. 78% ), 7 cases were laryngeal hemangiomas (5. 89% ), 4 cases were laryngeal webs and cyst (3. 36% ), 2 cases were vocal cord polyps ( 1.68% ), 2 cases were glottic incompetences ( 1.68% ),1 case was laryngeal papillomas(0. 84% ), 1 case was vocal code granulomas (0. 84% ), 1 case was glottis restricted by neck lymphangioma (0.84%); 4 cases were undetermined and 13 cases were no abnormalities. The percentage of patients with congenital heart diseases (19 cases)in vocal cord paralysis was 48. 72%. The proportion of vocal cord paralysis in younger group was higher than that in elder one ,their percentage were 50. 00%, 36. 67% and 17. 14% respectively ( x2 = 7. 18, P ＜ 0. 05). Conclusions A variety of causes can lead to persistent hoarseness in infants. The majority of them are vocal hypertrophy and hyperplasia, followed by vocal cord paralyse. Vocal cord paralysis is more common in younger infants than in elder ones, and the main causes are post-cardiac surgery and congenital heart disease.
