背景:气管发育不全,或者气管闭锁,是一种罕见的先天性异常.气管食管瘘(TEF)的存在可以帮助患有气管发育不全的新生儿呼吸。在这篇文章中,我们介绍了3例新生儿气管发育不全的独特病例和结局,并对文献进行了综述.
方法:本研究包括一个单中心病例系列,然后进行文献综述。病例报告是使用一家医院的书面和电子病历生成的。我们总结了三例新生儿气管发育不全的独特病例和结局,并对文献进行了回顾。
结果:我们确定了3例气管发育不全患者,出生时表现为严重紫癜,但没有自发性哭闹。经验丰富的儿科医生试图为婴儿插管,但未成功。随后,气管内导管被意外或故意放入食道,和氧饱和度水平改善。这表明TEF的气管发育不全。2例食管插管复苏后行手术干预。
结论:对于初次复苏时气管发育不全和TEF患者,食管插管可能是一种维持生命的通气支持。当新生儿出生时出现严重的紫癜和无声的哭闹时,临床医生应怀疑气管发育不全。应立即尝试食管插管。
BACKGROUND: Tracheal agenesis, or tracheal atresia, is a rare congenital anomaly. The presence of a tracheoesophageal fistula (TEF) can help with breathing for newborns with tracheal agenesis. In this article, we presented three unique cases and outcomes of neonates with tracheal agenesis along with a review of the literature.
METHODS: This study consisted of a single center case series followed by a review of literature. Case reports were generated using both written and electronic medical records from a single hospital. We summarized three unique cases and outcomes of neonates with tracheal agenesis and performed a review of the literature.
RESULTS: We identified three cases of tracheal agenesis presented with severe cyanosis without spontaneous crying upon birth. Experienced pediatricians attempted to intubate the babies but were unsuccessful. Endotracheal tubes were subsequently either accidentally or purposely placed into the esophagus, and oxygen saturation levels improved. This suggested tracheal agenesis with TEF. Two cases underwent surgical intervention after resuscitation with esophageal intubation.
CONCLUSIONS: Esophageal intubation may be a life-sustaining ventilation support for patients with tracheal agenesis and TEF at initial resuscitation. Clinicians should suspect tracheal agenesis when a newborn presents with severe cyanosis and voiceless crying upon birth, and esophageal intubation should be immediately attempted.