Clinical assessment and related intervention of neonatal upper airway obstruction

Abstract

Objective:To discuss the diagnosis and evaluation of upper airway obstruction in neonates, classify the possible causes of neonatal upper airway obstruction, establish a standardized diagnosis and treatment procedure to improve the of treatment efficacy. Method:Clinical data of 71 cases with upper airway obstruction history were retrospective analyzed, 38 cases were treated by combined medical and surgical treatment, 17 cases underwent medical treatment, 16 cases abandonment the treatment. The effectiveness of fibrolaryngoscope, CT, neck ultrasound, MRI and other results was evaluated, and to analyze the prognosis of the treatment, the outcomes and risk factors were also analysed, to evaluate risk factors associated with upper airway obstruction. Result:Fifty-five cases were cured or improved. The mortality rate of 16 children who gave up treatment and left hospital automatically was 81.25%（13/16）. The accuracy rate of flexible laryngoscope in detecting the level of upper airway obstruction was 100%, the coincidence rate of B-ultrasound for upper airway cystic occupation was 100%. Etiological order from high to low was congenital space-occupying lesions, congenital upper airway malformation, vocal cord paralysis, Pierre-Robin syndrome. The site of obstruction has a significant influence on the severity of upper airway obstruction（P<0.05）. The cure rate of the non-endotracheal intubation group was higher than that of the endotracheal intubation group（P<0.05）. Conclusion:The obstruction site of upper airway significantly affects the outcome and the severity of the disease. Upper airway space occupying lesions are the primary causes of upper airway obstruction in neonates. Early assessment and timely treatment can improve the cure rate and improve the prognosis. Internal medicine combined with surgical treatment is effective in relieving upper airway obstruction.