中国实用儿科杂志

中国实用儿科杂志 ›› 2025, Vol. 40 ›› Issue (9): 762-766.DOI: 10.19538/j.ek2025090611

• 论著 • 上一篇    下一篇

儿童气管狭窄53例临床分析

  

  1. 厦门大学附属第一医院儿科  厦门市儿科重点实验室  厦门大学医学院儿科医学研究所，福建  厦门  361003
  • 出版日期:2025-09-06 发布日期:2025-10-20
  • 通讯作者: 杨运刚，电子信箱：xmyyg@sina.com
  • 基金资助:
    国家重点研发项目（2022YFC2704803）

Clinical analysis of 53 cases of tracheal stenosis in children

  1. Department of Pediatrics，the First Affiliated Hospital of Xiamen University，Pediatric Key Laboratory of Xiamen，Institute of Pediatrics，School of Medicine，Xiamen University，Xiamen  361003，China
  • Online:2025-09-06 Published:2025-10-20

摘要： 目的　分析儿童气管狭窄的临床特点，对先天性气管狭窄与继发性气管狭窄的临床特征进行比较分析。方法　回顾性分析2012年1月1日至2021年12月31日在厦门大学附属第一医院儿内科通过支气管镜检查确诊的53例气管狭窄住院患儿的临床资料，并采用SPSS 28.0统计软件对临床数据进行统计学分析。结果　53例患儿中男30例，女23例，中位年龄8.7月龄，1岁以内患儿占72.2%。60%患儿以慢性呼吸道症状为主要表现，包括慢性咳嗽、痰鸣、喉鸣及反复喘息表现。53例患儿中，先天性气管狭窄25例，均为完全性气管环，气管各段均可累及；继发性狭窄28例，24例源于心血管系统压迫，主要源于主动脉系统的压迫，均为气管中下段外压狭窄，2例为气管内膜状物形成致管腔狭窄。先天性气管狭窄伴有其他气道畸形较继发性狭窄更多见，特别是气管支气管比例显著高于继发性狭窄。52例患儿经内科抗感染及气道管理治疗后好转出院。结论　气管狭窄多见于1岁以内婴儿，常表现为慢性呼吸道症状；胸部CT结合气管镜检查可准确评估患儿气管狭窄情况；先天性气管狭窄与继发性气管狭窄临床表现不同。

关键词: 气管狭窄, 支气管镜, 婴儿, 呼吸道症状

Abstract: Objective　To analyze the clinical characteristics of tracheal stenosis in pediatric patients and compare the clinical features between congenital and secondary tracheal stenosis. Methods　A retrospective analysis was conducted on clinical data of pediatric inpatients diagnosed with tracheal stenosis through bronchoscopy at the Department of Pediatrics，First Affiliated Hospital of Xiamen University from January 1，2012，to December 31，2021. Statistical analysis was performed using SPSS 28.0 software. Results　A total of 53 cases were included（30 males，23 females）with a median age of 8.7 months. Children under 1 year of age accounted for 72.2% of cases. Chronic respiratory symptoms were the predominant manifestation in 60% of patients， including chronic cough，stridor，laryngeal wheezing，and recurrent wheezing. Among the 53 cases，25 were diagnosed with congenital tracheal stenosis（CTS），all of which showed complete tracheal rings affecting various tracheal segments. Twenty-eight cases were secondary tracheal stenosis（STS），with 24 cases caused by cardiovascular compression，primarily from the aortic system，and all were external compression stenosis of the middle and lower trachea. Two cases presented with endotracheal membranous formation，resulting in luminal stenosis. Concomitant airway malformations were more prevalent in CTS compared to STS，with a significantly higher tracheal-bronchial ratio than STS. Fifty-two patients showed improvement after conservative medical management，including anti-infection therapy and airway management，and were discharged. Conclusion　Tracheal stenosis predominantly affects infants under one year of age，typically presenting with chronic respiratory symptoms. Chest CT combined with bronchoscopy can accurately evaluate pediatric tracheal stenosis. Clinical manifestations differ between congenital and secondary tracheal stenosis.

Key words: tracheal stenosis, bronchoscopy, infant, respiratory symptoms