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JAMA在線(xiàn)最新發(fā)表的一項(xiàng)研究顯示，對(duì)于需要避免氣管切開(kāi)同時(shí)患有先天性心臟?。–HD）的聲門(mén)下狹窄（SGS）患兒，球囊擴(kuò)張喉成形術(shù)是一種有價(jià)值的治療方法。

這項(xiàng)回顧性研究在一家三級(jí)學(xué)術(shù)性健康中心展開(kāi)，2006年1月1日至2011年12月31日間共有16例接受球囊擴(kuò)張喉成形術(shù)治療SGS并診斷為CHD的患兒納入了研究。主要療效指標(biāo)為臨床改善和是否避免氣管切開(kāi)。

研究結(jié)果發(fā)現(xiàn)，5位患者（3女2男）接受了總共11次針對(duì)SGS的球囊擴(kuò)張。首次接受擴(kuò)張時(shí)的年齡從1至4個(gè)月不等，這5位患者均患有III級(jí)SGS。僅有1位患者由于首次球囊擴(kuò)張失敗導(dǎo)致的厚聲門(mén)型網(wǎng)和相關(guān)SGS而需要?dú)夤芮虚_(kāi)求助來(lái)改善呼吸道通暢。剩余的4位患者均有長(zhǎng)期的癥狀改善并且成功的避免了氣管切開(kāi)。

OBJECTIVE To determine the utility of performing balloon dilation laryngoplasty of subglottic stenosis (SGS) in children with underlying congenital heart disease (CHD). DESIGN Retrospective study. SETTING Tertiary care academic health center. PATIENTS Children with an underlying diagnosis of CHD who subsequently underwent balloon dilation laryngoplasty for SGS from January 1, 2006, through December 31, 2011. MAIN OUTCOME MEASURES Clinical improvement and avoidance of tracheotomy. RESULTS We identified 16 children who had a diagnosis of CHD and underwent direct laryngoscopy and bronchoscopy. Five patients (3 girls and 2 boys) underwent a total of 11 balloon dilations for SGS. Their ages at initial dilation ranged from 1 to 4 months. All 5 patients had grade III SGS. Only 1 patient required a salvage tracheotomy for a thick glottic web and associated SGS after her first balloon dilation failed to improve airway patency. The remaining 4 patients have had long-term success in avoiding tracheotomy with symptomatic improvement. CONCLUSIONS Balloon dilation represents a valuable treatment option in patients with CHD and SGS in whom a tracheostomy should be avoided.