小兒喘鳴

Pediatric Stridor

李國森(Kuo-Sheng Lee) ； 王麟殿(Lin-Tien Wang) ； 楊政謙(Cheng-Chien Yang) ； 張克昌(Ko-Chang Chang)

《中華民國耳鼻喉科醫學雜誌》 34卷1期 (1999/01) Pp. 40-44

https://doi.org/10.6286/1999.34.1.40

摘要

背景：喘鳴是小兒科呼吸道疾症的重要症狀之一。在喘鳴的症患找出正確的病因，方可給予病患適當的處理。本文把近5年中，本科所遇到的小兒喘鳴患者，予以歸納分析，探討喘鳴的原因，盼能有助於對喘鳴的診斷及處置。
方法：自1992年6月起至1997年6月止，收集了388例因喘鳴而接受咽喉纖維內視鏡檢查的小兒病患。檢查設備為Olymput-P3 3.5mm口徑的軟式鼻咽喉纖維內視鏡，並以錄影設備記錄檢查結果。病人全部在局部麻醉下完成。
結果：病患388例中，男性243例，女性145例，男女比例為1.7比1。年齡分佈，最小為1天，最大為13歲。有35例找不出明顯的問題，因此歸類於不明原因的喘鳴。353例異常病患中，有40名有2項或以上的病變，合計400個異常。以病變數來看，依序為軟喉症230例（57.5％）、聲帶麻痺46例（11.5％）、聲門下區病變30例（7.5％）、感染症29例（7.3％）、喉咽部囊腫17例（4.3％）、氣管病變14例（3.5％）、聲門區肉芽腫6例（1.5％）、腫瘤5例（1.3％）及及其它23例（5.8％）
結論：喘鳴是小兒呼吸道病變的重要症狀之一。以軟式鼻咽纖維內視鏡作為診斷工具，並依其問題，早期予以治療，可以提供病患最大的助益。

關鍵字

喘鳴 ； 軟喉症 ； 纖維內視鏡檢查

並列摘要

Background: Stridor is one of the major signs of respiratory tract disease. We retrospectively reviewed patients with stridor over the past 5 years to analyzed the etiology.
Methods: From June 1992 through June 1997, we had 388 patients with striwas the Olympus-P3 with a fiberoptic head of 3.5 mm diameter. All procedures were performed under local anesthesia and the video images were recorded.
Results: Of the 388 patients, 243 were boys and 145 were girls. All were below the age of 13 years. In 35 cases, no definite etiology was found. In the remaining 353 cases, 400 anomalies were found, and 40 patients had at least two different lesions. Laryngomalacia accounted for stridor in 230 cases (57.5%), vocal palsy in 46 (11.5%), subglottic lesions in 30 (7.5%), infectious disease in 29 (7.3%), cysts in 17 (4.3%), tracheal lesions in 14 (3.5%), glottic granulomas in 6 (1.6%), tumors in 5 (1.3%) and miscellaneous causes in 23 (5.8%).
Conclusions: Fiberoptic endoscopy is a powerful diagnostic tool in respiratory tract disease, enabling early diagnosis and proper management of pediatric stridor.

並列關鍵字

sridor ； larynogmalcia ； fiberoptic endoscopy