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本文报导100例婴幼儿喉麻痹,指出呼吸道阻塞、声音嘶哑以及误吸是喉麻痹的主要症状。早期发现并给予适当治疗可防止缺氧或下呼吸道感染等威胁生命的并发症。小儿喉麻痹原因有中枢神经系疾病、分娩损伤(包括剖腹产与使用产钳等)、Arnold-Chiari畸形、脑水肿、脊髓脊膜膨出(meningomyelocele)、颈部钝器伤、颈部肿瘤、特发性及家族性原因等。所谓特发性喉麻痹系指经多方检查仍不能明确病因者;家族性原因系指一患儿的母亲及妹妹亦有伴进行性腓神经性肌萎缩的双侧声带外展麻痹。各组出现喉麻痹症状的平均时间为38天,其中以分娩损伤出现最早,中枢神经系疾病在10天内出现,脊髓脊膜膨出在47天。喉麻痹症状的严重程度依病因而不同,吸气性喘鸣为最常见症状,在中枢神经系疾病、手术、分娩损伤及脊髓脊膜膨出中最明显;严重的气道阻塞多见于手术及分娩损伤的双侧外展麻痹;吞咽困难多见于中枢神经系疾病的喉麻痹;误吸发生于喉部感觉丧失、脑神经病变及一侧或双侧声带处于外展位的患儿,常是喉上及喉返神经均受累的表现。在本文资料中,无论单侧或双侧麻痹,失音并不常见。窒息发生于某些中枢神经系疾病及脊髓脊膜膨出者,需作气管造口术改善通气。在某些患儿则需用横膈起搏器(diaphragm pacemaker)以控制呼吸。
This article reports 100 cases of infant laryngeal paralysis, pointed out that airway obstruction, hoarseness and aspiration are the main symptoms of laryngopharyngeal paralysis. Early detection and proper treatment can prevent life-threatening complications such as hypoxia or lower respiratory tract infections. Causes of pediatric laryngeal paralysis include central nervous system disorders, labor injury (including caesarean section and use of forceps, etc.), Arnold-Chiari malformations, cerebral edema, meningomyeloceles, blunt neck injuries, neck tumors, idiopathic Sexual and familial reasons. The so-called idiopathic laryngotracheal refers to the multi-party test is still not clear cause; familial reason refers to a child’s mother and sister also had bilateral calcaneal peroneal nerve atrophy with vocal cord abduction. The mean duration of laryngotracheal symptoms in each group was 38 days, with the earliest onset of labor injury, central nervous system disease occurring within 10 days, and myelomeningocele at 47 days. The severity of the symptoms of laryngotrachealis varies according to the cause, with aspiration wheezing being the most common symptom, most notable in CNS disorders, surgery, labor injury and meningocele. Serious airway obstruction is more common in surgery and Bilateral abduction paralysis of labor injury; dysphagia common in central nervous system diseases laryngotracheal; aspiration occurs in the laryngeal sensory loss, neuropathy and one or both vocal cords in the abduction position in children, often throat Upper and recurrent laryngeal nerve are involved in the performance. In our data, aphonia is not common, regardless of unilateral or bilateral paralysis. Asphyxia occurs in some central nervous system diseases and spinal meningocele who need to be tracheostomy to improve ventilation. In some children, a diaphragm pacemaker is required to control breathing.