婴儿先天性喘鸣合并宫内感染1例临床观察

V. Kozlov, O. Ostrovskaya, S. Gandurov, Y. B. Puchkov, Yu. L. Puchkova, E. Yakovlev, S. Pichugina, M. Vlasova, R. Telepneva, O. Lebed’ko
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摘要

介绍。近年来,新生儿和婴儿出现与上呼吸道梗阻相关的喘鸣或嘈杂呼吸的频率越来越高。喘鸣最常见的原因是喉发育的先天性病理-喉软化。喉软化症临床病程的严重程度及其预后取决于先天性病理的解剖变异以及是否存在先天性和获得性伴发的获得性合并症。的目标。一例婴儿先天性喘鸣合并宫内感染的临床病例。结果。对一名从8天起就出现喘鸣临床症状的儿童的观察,该儿童的母亲患有复杂的产科健全性疾病,并在妊娠早期患有传染病;病理性分娩(紧急剖腹产)。在一个儿童中发现了伴有喉狭窄症状的II型喉软化症。这种疾病的严重程度不仅是由于喉畸形的解剖变异,而且还由于先天性(心脏病、胸部变形)和后天(围产期脑病)病理的结合。合并病理在孩子的存在,显然,是由于单一的致病机制宫内病毒-细菌感染,证实了胎盘形态检查的结果。呼吸衰竭的增加需要手术干预。激光内窥镜下声门上成形术完全停止了喘鸣呼吸。结论。这一观察结果说明宫内感染的结果是先天性和后天性的综合病理在儿童的发展;说明有并发症的产科健忘症妇女需要及时诊断和治疗传染病。早期诊断,明确儿童因喉畸形(喉软化II型)引起喘鸣的原因,成功的手术治疗使上呼吸道通畅完全恢复。
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Clinical observation of an infant with congenital stridor associated with intrauterine infection
Introduction. The frequency of occurrence of stridor or noisy breathing associated with obstruction of the upper respiratory tract in newborns and infants is increasing nowadays. The most common cause of stridor is a congenital pathology of laryngeal development – laryngomalacia. The severity of the clinical course of laryngomalacia and its prognosis depends on the anatomical variant of congenital pathology and the presence of congenital and acquired concomitant acquired comorbidities. Aim. Demonstration of a clinical case of congenital stridor associated with intrauterine infection in an infant. Results. An observation of a child with a severed clinical picture of stridor breathing from the age of 8 days, born from a mother with complicated obstetric anamnesis who had an infectious disease in early pregnancy; pathological childbirth (emergency c-section). The laryngomalacia type II with symptoms of laryngeal stenosis was detected in a child. The severity of the disease was due not only to the anatomical variant of the laryngeal malformation, but also to the presence of a combined congenital (heart disease, chest deformation) and acquired (perinatal encephalopathy) pathology. The presence of combined pathology in the child, apparently, is due to a single etiopathogenetic mechanism of intrauterine viral-bacterial infection, confirmed by the results of morphological examination of the placenta. The increase in respiratory failure required surgical intervention. Laser endoscopic supraglottoplasty completely stopped stridor breathing. Conclusion. This observation illustrates the outcome of intrauterine infection as the development of a combined congenital and acquired pathology in a child; indicates the need for timely diagnosis and treatment of infectious diseases in women with complicated obstetric anamnesis. Early diagnosis, clarification of the cause of stridor in a child due to laryngeal malformations (laryngomalacia type II), successful surgical treatment allowed to fully restore the patency of the upper respiratory tract. 
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