congenital laryngeal atresia
Introduction
Introduction to congenital laryngeal atresia In the embryonic stage, the development of the laryngeal process is blocked, the laryngeal cavity is not formed, and the laryngeal atresia cannot be ventilated at birth. It is called congenital laryngeal atresia, and there are two kinds of membranous or cartilage. No matter any atresia, there is often a small hole in the back of the larynx. , called the pharyngeal duct. Although the child has no breathing after birth, but there is obvious breathing action, this can be caused by shock, cerebral hemorrhage, etc., but there are obvious breathing movements, which can be distinguished from apnea caused by shock, cerebral hemorrhage, etc.; When the child's color is normal, the hair strand appears shortly after the umbilical cord is ligated, which can be differentiated from the heart sputum. No crying and throat snoring can be distinguished from other throat or tracheal abnormalities. If the child is not treated immediately, it will die more than soon after birth. If the newborn is found to have respiratory action without any sound or air inhalation, the baby bronchoscope should be occluded into the trachea under direct laryngoscopy, oxygen and artificial respiration can be used to save the child. . In the case of bony atresia, a tracheotomy should be performed immediately. basic knowledge The proportion of illness: 0.002% Susceptible population: newborn Mode of infection: non-infectious Complications: neonatal asphyxia
Cause
Cause of congenital laryngeal atresia
Causes and mechanisms of the disease:
Congenital esophageal atresia is a common severe malformation in neonates, and the cause of the formation is unclear. Some scholars believe that it is related to inflammation, vascular development or genetic factors. Reduced supply of blood in the foregut can lead to occlusion. Older women, low birth weight children are prone to occur, and 1/3 are premature infants.
It is currently believed that the disease is 19-23 days of conception. The human primitive gut is only a single layer of cells, and the esophageal trachea is caused by this. The two are a total of one tube. At the fifth week, the esophagus is grown by a mesoderm. Tracheal segmentation, first differentiated from the ventral canal to the carina and develop into the respiratory system, the dorsal tube extends to the head, differentiates into the esophagus, so that the two are separated by the pharynx.
Prevention
Congenital laryngeal atresia prevention
Pregnant women with excessive amniotic fluid should be alert to the possibility of congenital malformations. Amniocentesis and amniotic fluid alpha-fetoprotein and acetylcholinesterase increase the prenatal diagnosis.
Complication
Congenital laryngeal atresia Complications, neonatal asphyxia
If the child is not treated immediately, due to a laryngeal atresia, the patient cannot breathe and breathe more than soon after birth.
Symptom
Congenital laryngeal atresia symptoms Common symptoms "Four concave signs" after birth Bleeding respiratory tract obstruction
Although the child has no breathing after birth, but there is obvious breathing action, this can be caused by shock, cerebral hemorrhage, etc., but there are obvious breathing movements, which can be distinguished from apnea caused by shock, cerebral hemorrhage, etc.; When the child's color is normal, the hair strand appears shortly after the umbilical cord is ligated, which can be differentiated from the heart sputum. No crying and throat snoring can be distinguished from other throat or tracheal abnormalities.
After the child was born, there was no breathing or crying. The "four concave sign" was seen, but there was no air inhalation. At the time of birth, the color of the child was normal, but after the umbilical cord was ligated, it soon became convulsed.
Examine
Congenital laryngeal atresia
X-ray examination is simple and accurate, and has a decisive diagnostic significance for this disease. The chest and abdomen should be routinely seen or photographed. If there is no gas in the abdomen, it is characterized by esophageal atresia; if there is esophageal tracheal fistula, there may be gas accumulation in the stomach and intestine. Therefore, there is no gas in the abdominal cavity to completely exclude the esophageal atresia.
Diagnosis
Diagnosis and diagnosis of congenital laryngeal atresia
Although the child has no breathing after birth, there is obvious breathing action, which can be caused by shock, cerebral hemorrhage, etc., but there are obvious breathing movements, which can be distinguished from apnea caused by shock, cerebral hemorrhage, etc.; The color of the child is normal. Hair cyanosis occurs shortly after ligation of the umbilical cord. It can be differentiated from cardiac hair bun, and no crying and throat can be distinguished from other laryngeal or tracheal abnormalities.
