Title

小兒細菌性喉氣管炎-30例分析

Translated Titles

Bacterial Laryngotracheitis in Pediatrics-An Analysis of 30 Cases

DOI

10.6286/2005.40.1.26

Authors

林正隆(Cheng-Lung Lin);李國森(Kuo-Sheng Lee);楊政謙(Cheng-Chien Yang)

Key Words

喉氣管炎 ; 哮吼 ; 會厭炎 ; 環狀軟骨 ; 狗吠狀咳嗽 ; laryngotracheitis ; croup ; epiglottitis ; cricoid ; barking cough

PublicationName

臺灣耳鼻喉頭頸外科雜誌

Volume or Term/Year and Month of Publication

40卷1期(2005 / 01 / 01)

Page #

26 - 32

Content Language

繁體中文

Chinese Abstract

背景:細菌性喉氣管炎是一種小兒呼吸道細菌感染中相當嚴重的一種疾病,病患會有嚴重聲門下水腫及大量的膿性分泌物造成急性呼吸道阻塞,如果沒有及時的治療很容易造成生命危險。本文針對其好發年齡、好發季節、臨床症狀、抽血檢驗數據表現、致病菌、抗生素的治療、病患平均住院天數及併發症與後遺症的處理,加以討論及分析。 方法:自l993年8月至2003年8月,本院共經歷30例細菌性喉氣管炎病例。所有病患均接受抽血、胸部X光及軟式喉頭內視鏡檢查,並使用抗生素治療。 結果:這30個病例,年齡自l月大至8歲不等,好發年齡為3歲以下有19名,佔63.3%。好發月份在6、7、8月有14名,佔46.7%。臨床症狀以發燒、咳嗽、喘嗚、聲音沙啞及呼吸急促等最常見。入院時抽血之白血球大於15,000/立方公厘有18名佔60%。致病菌種以綠膿桿菌(Pseudomonas aeruginosa)最常見(46.7%),其次是α-溶血性鏈球菌(α-hemolytic streptococcus)(40.0%)及金黃色葡萄球菌 (Staphylococcus aureus)(20.0%)。 結論:細菌性喉氣管炎很容易引起呼吸窘迫而造成生命的威脅,有些甚至引起呼吸道的後遺症,醫師面對這類病患必須迅速做出適當的診斷,軟式喉頭內視鏡的使用可提供耳鼻喉醫師做出快速的鑑別診斷,此外,使用適當的抗生素治療及適當的呼吸道照顧,是有效治療細菌性喉氣管炎的不二法門。

English Abstract

BACKGROUND: Bacterial layngotracheitis is an acute infection in the upper airway of children with severe subglottic edema and purulent tracheal secretion. It may lead to rapid life-threatening airway obstruction, if left without appropriate treatment. In this work, retrospectively incidence of disease regarding season and age of subjects, symptoms and signs, hematologic study, causative organisms, choice of antibiotics and disease related complications were analyzed. METHOD: Between Aug. 1993 and Aug. 2003, 30 patients with bacterial laryngotracheitis were admitted. All patients received routine hematologic study, chest x-ray, flexible laryngoscopic examination and antibiotics treatment. RESULTS: Thirty cases were analyzed, comprising of 23 males and 9 females, ranging from 1 month to 8 years old. The incidence in subjects less than 3 years of age is 63.3%. The incidence of disease was highest in June, July and August (46.7%). Fever, cough, stridor, hoarseness and tachypnea were the most common clinical symptoms. Leukocytosis was revealed by hematologic study (WBC>15000/mm^3 60%). Pseudomonas aeruginosa (46.7%) was the most common bacteria isolated, followed by a-hemolytic streptococcus (40.0%) and Staphylococcus aureus (20.0%) CONCLUSIONS: Bacterial laryngotracheitis is a life-threatening disease due to resulting respiratory distress. The physician must be able to make a prompt diagnosis quickly. Flexible laryngoscope provides the otolaryngologist the ability to make an instant differential diagnosis. In addition, administration of empiric antibiotics and maintenance of an adequate airway are the principles of treatment.

Topic Category 醫藥衛生 > 外科