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| 1 | 保守疗法治疗先天性气管狭窄的效果:一项循证长期随访研究显示文摘Background/Purpose:Surgery has been the management of choice for severe congenital tracheal stenosis (CTS). The role of conservative management of CTS however is not clear. The aim of this study is to characterize the natural history of CTS,review the radiologic evidence of tracheal growth,and evaluate the clinical outcome and selection criteria of conservative management of CTS. Methods:A retrospective study was carried out on 22 consecutive children with symptomatic CTS admitted into a single institution between 1982 and 2001. The patients were categorized into operation (n = 11) and observation(n = 11) groups. Six patients of the observation group were followed up with serial computed tomography scan. Their tracheal growth was compared with that of healthy children of the same age. Results:The mortality rates of observation and operation groups were 9%and 27%,respectively,although the latter group consisted of more severely affected patients. The pathologic categorization of the CTS influenced the survival rates (P = 0.046,χ2),with the long segment type having the worst prognosis (67%). Serial computed tomography scans of 6 conservatively managed patients revealed that all stenotic tracheas continued to grow (P = .039,2-tailed paired Student’s t test). Of the 6 stenotic tracheas,5 grew at a faster-than normalrate,and the stenotic tracheal diameters approached those of normal diameters by the age of 9 years. Conclusions:The management of patients with symptomatic CTS should be individualized. A selected group of patients with CTS can be safely managed nonoperatively. | Manson D.E. Forte V. P.C.W. Kim 刘凯 | 2006 | 世界核心医学期刊文摘(儿科学分册)2006，0，12： | 5 |
| 2 | 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显示文摘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. | Chiu P.P.L. Kim P.C.W. 刘凯 | 2006 | 世界核心医学期刊文摘(儿科学分册)2006，2，5： | 3 |
| 3 | 10年来在气管软化和(或)支气管软化的处理中应用气管/支气管腔内支架术是否优于主动脉固定术 | Valerie E.P. Durrant A.C. Forte V. P.C.W. Kim 郭战宏 | 2005 | 世界核心医学期刊文摘(儿科学分册)2005，0，12： | 0 |
| 4 | 先天性气管狭窄的治疗新挑战:一种个体化的治疗方法 | Chiu P.P.L. Kim P.C.W. Forte V. 贺莉 | 2005 | 世界核心医学期刊文摘(儿科学分册)2005，0，11： | 0 |
| 5 | 临床表现明显的血管环伴先天性气管狭窄患儿的长期预后显示文摘Aim: Congenital tracheal stenosis (CTS) associated with vascular rings (VRs) is considered a secondary condition,but relative indications for selective VRs or combined VR and CTS repairs are unclear. Here,we report long-term outcomes after VR repair associated with tracheal narrowing (TN). Method: Retrospective analysis of patients admitted to a single institution with VR from 1982 to 2004. Of 131 patients with VR (Cardiac Registry Database),29 (19 males,10 females; age range,0 days-4 years) associated with symptomatic TN. Patients were followed until age 18 years. Results: One hundred thirty-one patients with VR were categorized into 3 treatment groups. There were 102 patients with VR with no symptomatic TN treated by VR repair (4 deaths,4% mortality). Of the 29 patients with VR + TN symptoms,16 were treated by selective VR repair (mean age,5.3 months; range,17-288 days) with 3 deaths (19% mortality) and 13 underwent combined VR and CTS repairs (mean age,11 months; range,1 day-4 years) with 6 deaths (46% mortality),for an overall mortality of 31% (P < 0.01,χ 2 test). Of the 102 patients with VR,17 had intracardiac anomalies with 3 deaths (18% mortality). In contrast,7 of 29 patients with VR with TN and intracardiac anomalies died 4(57% mortality); 3 patients in combined cardiac and CTS repairs (2 deaths,67% mortality) and 4 in selective VR repairs (2 deaths,50% mortality). Conclusions: Not all cases of TN associated with VR require combined repairs. The presence of TN and/or intracardiac anomalies in patients with VR,however,increases mortality risk to the repair of VR. Surgical decision requires individualized clinical pathway. | Chiu P.P.L. Rusan M. Williams W.G. P.C.W. Kim 刘凯 | 2006 | 世界核心医学期刊文摘(儿科学分册)2006，0，9： | 0 |
| 6 | 高危神经母细胞瘤强化治疗方案中的外科问题 | Cantos M.F. Gerstle J.T. Irwin M.S. P.C.W. Kim 李丹 | 2006 | 世界核心医学期刊文摘(儿科学分册)2006，0，A10： | 0 |
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