先天性支气管狭窄手术治疗的预测因子:一项多中心文献分析

来源 :世界核心医学期刊文摘(儿科学分册) | 被引量 : 0次 | 上传用户:dfly1818
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Background: Congenital tracheal stenosis (CTS) often requires urgent surgical intervention. We evaluated prognostic factors to determine the risks of surgical interventions by conducting a retrospective review of recent case series. Methods: Cases of CTS between 2002 and 2004 from our institution and recently published series that provided primary data on the demographics, complications, and outcomes of patients with CTS were analyzed. Univariate, model fit, and multivariate logistic regression analyses were performed using the SAS Statistical Program. Results: There were 68 patients who were treated (cartilage patch tracheoplasty, n = 31; slide tracheoplasty, n = 37), with 19 deaths (overall mortality = 28%). A total of 10 patients who underwent cartilage patch tracheoplasty died (32%mortality), whereas only 9 patients died following slide tracheoplasty (24%mortality). A total of 8 of 11 patients who were repaired at the age of 1 month or younger died (73%mortality), whereas only 11 of 57 patients who were repaired at an age older than 1 month died (19%mortality) (P = .04). A total of 10 of 19 patients with CTS who had comorbid intracardiac anomalies died following CTS repair (53%mortality), whereas only 9 of 49 patients with CTS who did not have intracardiac anomalies died (18%mortality) (P = .02). Conclusions: This is the first report on the prognostic factors determining surgical outcomes for CTS. The highest mortality rate was observed in CTS patients younger than 1 month and in those with intracardiac anomalies. Congenital tracheal stenosis repairs in these patient subgroups should be considered with caution. Methods for CTS between 2002 and 2004 from our institution and recently published series that provided primary data on the demographics, complications, and outcomes of patients with CTS were analyzed. Univariate, model fit, and multivariate logistic regression analyzes were performed using the SAS Statistical Program. Results: There were 68 patients who were treated (cartilage patch tracheoplasty, n = 31; slide tracheoplasty, n = 37), with 19 deaths (overall mortality = 28%). A total of 10 patients who underwent cartilage patch tracheoplasty died (32% mortality), only only 9 patients died following slide tracheoplasty (24% mortality). A total of 8 of 11 patients who were repaired at the age of 1 month or younger died (73% mortality), only only 11 o f 57 patients who were repaired at an age older than 1 month died (19% mortality (P = .04). A total of 10 of 19 patients with CTS who had comorbid intracardiac anomalies died following CTS repair (53% mortality) Conclusions: This is the first report on the prognostic factors determining determining the outcomes of CTS. The highest mortality rate was observed in CTS patients younger than 1 month and in those with intracardiac anomalies. Congenital tracheal stenosis repairs in these patient subgroups should be considered with caution.
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