Clinical Classification, Diagnosis And Treatment Of Laryngeal Stridor In 58 Neonates

Objective:To analyze the clinical data of 58 cases of neonatal laryngeal stridor,combined with clinical symptoms,to grade the severity of the disease,and to explore the diagnosis and treatment of different degrees of laryngeal stridor.Methods:The clinical data of 58 newborns with laryngeal stridor admitted in the Department of Neonatal Pediatrics of the first Hospital of Jilin University from January 2015 to January2019 were analyzed retrospectively.According to the grading of clinical manifestations,the general condition,diagnosis,treatment and prognosis of children with different grades were analyzed.Result:1.A total of 58 cases of neonatal laryngeal wheezing were included,including mild(n = 18),moderate(n = 28)and severe(n = 12).A total of 50 cases were examined by bronchoscopy to determine the cause,of which laryngomalacia accounted for 62.1%,and laryngomalaciawas the most common cause in mild,moderate and severe groups.Other common causes included tongue root cyst,glossoptosis,vocal cord paralysis and laryngeal web,and there was no significant difference among the three groups(P = 0.247).2.The rate of bronchoscopy in the severe group was100%,which was higher than that in the mild group(50%)and moderate group(28.6%),with P values of 0.004 and<0.001.The surgical rate of the severe group was 41.7%,significantly higher than that of the mild group(0%)and the moderate group(3.6%),with P values of 0.006 and 0.006.The mortality rate of the severe group was 41.7%,which was significantly higher than that of the mild group(0%)and the moderate group(3.6%),with P values of 0.006 and 0.006.The average recovery time of the severe group was 5.8±8.8months,significantly lower than that of the mild group(14.4 ±5.3 months)and the moderate group(13.0 ±9.6months),with P value of 0.006 and 0.013.3.The readmission rate of the moderate group was71.4%,significantly higher than that of the mild group(11.1%)and the severe group(8.3%),with P values of <0.001 and < 0.001.Bronchoscopy could significantly reduce the re-hospitalization rate of moderate neonatal laryngeal stridor,with P values of <0.001.Conclusion:1.In order to make a better individual diagnosis and treatment of neonatal laryngeal stridor,it needs to be graded according to the clinical symptoms.2.For moderate neonates with laryngeal stridor,bronchoscopy should be performed as soon as possible to determine the causes and treatments.It can not only reduce the risk of re-hospitalization due to aggravation of symptoms or complicated infections,but also improve the prognosis and the quality of life of the patients.3.For severe neonates with laryngeal stridor,the prognosis is worse than mild and moderate.It is suggested that bronchoscopy should be performed as soon as possible to determine the cause and undergo surgical treatment actively,so as to reduce the mortality and shorten the recovery time.