RESUMO
Objective:To investigate the value of flexible bronchoscopy and neck ultrasound in percutaneous dilatational tracheotomy (PDT) in infants.Methods:The clinical data of 24 patients, who underwent flexible bronchoscopy and neck ultrasound assisted PDT in the Center for Respiratory Intervention, Children′s Hospital Affiliated to Shandong University from December 2018 to May 2021, were retrospectively analyzed.Of the 24 cases, 12 were male and 12 female.The male to female ratio was 1∶1.The age range was 21 days to 2 years (median: 5 months). The median mass was 5.8 kg.During the PDT, neck ultrasound was used to assess the thyroid position and vascular shape of vessels.After determining the puncture approach and marking the tracheostomy site, the PDT was performed under the guidance of flexible bronchoscopy.Results:Before surgery, 19 children (79.2%) had received continuous endotracheal intubation mechanical ventilation support, 2 children (8.3%) were treated by intermittent endotracheal intubation mechanical ventilation support therapy, and 3 children (12.5%) were supported by the non-invasive ventilator.There were 9 cases (37.5%) of congenital upper respiratory tract malformation, 8 cases (33.3%) of bilateral vocal cord paralysis, 3 cases (12.5%) of upper respiratory tract neoplastic diseases, 2 cases (8.3%) of surgical evacuation difficulties, and 2 cases (8.3%) of neuromuscular disease.All 24 patients successfully completed the operation within 30 min, with bleeding volume less than 5 mL and no intraoperative complications.Conclusions:Flexible bronchoscopy and neck ultrasound can assist in the successful PDT in infants, significantly reduce the difficulty and improve the safety of PDT.
RESUMO
Objective To study the influencing factors and clinical significance of ultrasonic quantitative analysis of the hip-flexion coronal section in the normal infants.Methods Totally 100 normal infants were enrolled.Angle α,angle β and FHC on different positions(mild-flexion and flexion of the hip) were mearured.And angle β on different points(the labrum central and the acetabular tips) were measured.The variation of the measurement index between different positions were analyzed.Results ①There was no significant difference in angle α between the neutral position and hip-flexion position (P ＞0.05).② FHC decreased in the hip-flexion position,and there was significant difference compared with the neutral position (P ＜0.05).③βc were greater than βt in the two positions (P ＜0.05);βc and βt were all greater in hip-flexion position than those in neutral position,the difference was statistically significant (P ＜0.05).Conclusions The results obtained from angle α is stable under the coronal flexion view of the normal infants,and does not vary with changing position.The change of the angle β and FHC with the hip flexion could be used to evaluate the stability of the hip.Measured angle β on the labrum tip has good repeatability.So this point should be selected to measure the angle β.