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首页> 外文期刊>Journal of paediatrics and child health >Multidisciplinary approach to paediatric aerodigestive disorders: A single-centre longitudinal observational study
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Multidisciplinary approach to paediatric aerodigestive disorders: A single-centre longitudinal observational study

机译：儿科炎症障碍的多学科方法：单中心纵向观察研究

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Aim Aerodigestive clinics (ADCs) are multidisciplinary programmes for the care of children with complex congenital or acquired conditions affecting breathing, swallowing and growth. Our objective was to describe the demographic, clinical, etiological and investigational profile of children attending the inaugural ADC at a tertiary paediatric centre in Queensland. Methods Children referred to the ADC at Queensland Children's Hospital from August 2018 to December 2019 were included. Data on clinical, growth and lung function parameters, bronchoscopy and upper gastrointestinal endoscopy findings, thoracic imaging and comorbidities were retrospectively analysed. Results Fifty-six children (median (range) age 4 years (3 months-15 years); 18 female) attended the ADC during this 17-month period. Forty-six (82%) children had previous oesophageal atresia with tracheo-oesophageal fistula; 43 of these were type C. Previous isolated oesophageal atresia, congenital diaphragmatic hernia and congenital pulmonary malformation were the underlying disorder in three (5%) children each, with one child having a repaired laryngeal cleft. Vertebral Anal Tracheo Esophageal Renal Limb anomalies (VACTERL)/Vertebral Anal Tracheo Esophageal renal anomalies (VATER) association was seen in 21 (38%) children. Growth was adequate (median weight and body mass indexz-score -0.63 and -0.48, respectively). Thirty-four (61%) children reported ongoing wet cough, with 12 (21%) requiring previous hospital admission for lower respiratory tract infection. Fourteen (25%) had bronchiectasis on computed tomography chest and 33 (59%) had clinical tracheomalacia, apparent on bronchoscopic examination in 21 patients. Dysphagia was reported in 15 (27%) children, 11 (20%) were gastrostomy feed-dependent and 5 (9%) had biopsy-proven eosinophilic oesophagitis. Conclusion High proportion of children attending the ADC have ongoing respiratory symptoms resulting in chronic pulmonary suppuration and bronchiectasis. Potential benefits of this model of care need to be studied prospectively to better understand the outcomes.
机译：目的空气消化诊所（ADC）是一个多学科的项目，旨在为患有影响呼吸、吞咽和生长的复杂先天性或后天性疾病的儿童提供护理。我们的目的是描述昆士兰一家三级儿科中心参加首届ADC的儿童的人口统计学、临床、病因学和研究概况。方法纳入2018年8月至2019年12月在昆士兰儿童医院接受ADC治疗的儿童。回顾性分析临床、生长和肺功能参数、支气管镜和上消化道内镜检查结果、胸部影像学和合并症的数据。结果56名儿童（中位数（范围）年龄4岁（3个月-15岁）；18名女性）在这17个月期间参加了ADC。46名（82%）儿童曾有食管闭锁伴气管食管瘘；其中43例为C型。先前的孤立性食管闭锁、先天性膈疝和先天性肺畸形是三（5%）名儿童的潜在疾病，其中一名儿童的喉裂已修复。在21名（38%）儿童中发现椎体-肛门-气管-食管-肾肢体异常（VACTERL）/椎体-肛门-气管-食管-肾异常（VATER）相关。生长良好（体重和体重指数中位数分别为-0.63和-0.48）。34名（61%）儿童报告持续湿咳，其中12名（21%）因下呼吸道感染需要入院治疗。在21例患者中，14例（25%）在胸部计算机断层扫描中出现支气管扩张，33例（59%）出现临床气管软化。据报道，15名（27%）儿童出现吞咽困难，11名（20%）依赖胃造口术，5名（9%）经活检证实为嗜酸性食管炎。结论参加ADC的儿童中，有很大比例存在持续的呼吸道症状，导致慢性肺化脓和支气管扩张。需要对这种护理模式的潜在益处进行前瞻性研究，以便更好地了解结果。

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