CAJ | 학술논문

目的探讨单纯性气管食管瘘的早期诊断及治疗方法.方法回顾性分析2006年2月至2013年2月收治的12例单纯性气管食管瘘的临床资料.12例患儿均行食管造影及纤维支气管镜检查,食管造影发现气管食管瘘11例,诊断率为91.7％,气管食管瘘的位置:瘘位于位于C7水平2例,C7～T1水平2例,T1水平1例,T1～T2水平2例,T2～T3水平3例,T3水平1例.经颈部切口手术10例,经右胸膜外手术2例.结果治愈11例,1例经胸膜外手术者出现吻合口瘘,保守治疗愈.随访患儿均生长发育同正常同龄儿,未见瘘复发.1例死于肺炎呼吸衰竭.结论先天性气管食管瘘少见,但对于可疑者及时的食管造影及纤维支气管镜检查可明确诊断,绝大多数患儿可经颈部入路修补气管食管瘘.
목적 탐토단순성기관식관루적조기진단급치료방법.방법 회고성분석2006년2월지2013년2월수치적12례단순성기관식관루적림상자료.12례환인균행식관조영급섬유지기관경검사,식관조영발현기관식관루11례,진단솔위91.7％,기관식관루적위치:루위우위우C7수평2례,C7～T1수평2례,T1수평1례,T1～T2수평2례,T2～T3수평3례,T3수평1례.경경부절구수술10례,경우흉막외수술2례.결과 치유11례,1례경흉막외수술자출현문합구루,보수치료유.수방환인균생장발육동정상동령인,미견루복발.1례사우폐염호흡쇠갈.결론 선천성기관식관루소견,단대우가의자급시적식관조영급섬유지기관경검사가명학진단,절대다수환인가경경부입로수보기관식관루.
Objective To present the methods of early diagnosis and management of isolated tracheoesophageal fistula(ITEF).Methods The medical records of 12 babies with ITEF were analyzed retrospectively.The fistula was noted by contrast esophagography and/or bronchoscopy.The fistula located at C7 on 2 cases,at C7-T1 on 2,at T1 on 1,at T1-T2 on 2,at T2-T3 on 3,and at T3 on 1.The fistula was repaired through cervical approach on 10 cases and the other 2 through extrapleural approach.Results Ten babies recovered uneventfully.One who underwent fistula repair through extrapleural approach had anastomotic leak and was cured by conservative treatment.One older baby died of severe pulmonary infection and respiratory failure.Conclusions ITEF is a rare congenital anomaly with chromic morbidities.The diagnosis of ITEF should be suspected if baby chokes on attempting to feed and has cyanotic spells in the first day of life,and the diagnosis can be confirmed by contrast esophagography and bronchoscopy.A timely repair of ITEF can be performed through cervical approach successfully in overwhelming majority babies.