Đặc điểm lâm sàng, cận lâm sàng và điều trị của bướu máu hạ thanh môn ở trẻ nhũ nhi tại Khoa Hô hấp 1, Bệnh viện Nhi đồng 2 từ 01/2016 đến tháng 02/2022

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Tác giả: Thị Thanh Hồng Đoàn, Thị Mỹ Phượng Lê, Thị Thanh Thảo Lê, Thị Thanh Thủy Lê, Thị Kim Anh Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại: 618.9 Pediatrics and geriatrics

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 152-159

Bộ sưu tập: Metadata

ID: 500524

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Mô tả các đặc điểm lâm sàng, cận lâm sàng, và điều trị của trẻ nhũ nhi được chẩn đoán xác định bướu máu hạ thanh môn tại khoa Hô Hấp 1 Bệnh viện Nhi Đồng 2 từ tháng 1/2016 đến tháng 02/2022. Đối tượng phương pháp nghiên cứu: mô tả 13 trẻ nhũ nhi được chẩn đoán bướu máu hạ thanh môn tại khoa Hô Hấp 1 Bệnh viện Nhi Đồng 2. Kết quả: Trong 13 bệnh nhân: nữ/nam: 1,2/1. Tuổi nhập viện: nhiều nhất là 2 tháng (38,4%). Thời gian khởi phát triệu chứng đa số là lúc trẻ được 1-2 tháng tuổi, thở rít là triệu chứng thường gặp nhất (92,3%). Có 30,7 % bệnh nhân có bướu máu da ở các vị trí cằm, hàm dưới, tai hai bên có bướu máu hạ thanh môn. Bướu máu hạ thanh môn được ghi nhận trên nội soi phế quản đều gây hẹp ở độ 2 và độ 3. CT ngực có cản quang chỉ ghi nhận được bướu máu hạ thanh môn ở 57% bệnh nhân được chụp. Tất cả bệnh nhân đều đáp ứng tốt với điều trị propranolol đơn độc, liều điều trị trung bình là 2-3 mg/kg/ngày, với thời gian điều trị trên 12 tháng và thường chấm dứt khi bệnh nhân ≥ 15 tháng tuổi. Trong suốt quá trình điều trị không ghi nhận bất kì tác dụng phụ nghiêm trọng nào. Hiện tại chưa ghi nhận ca nào tái phát sau ngưng điều trị Kết luận: Bướu máu hạ thanh môn ở trẻ nhũ nhi có biểu hiện đặc trưng là thở rít, thường khởi phát sớm lúc trẻ 1-2 tháng tuổi và có thể phát hiện sớm nhờ nội soi phế quản và CT ngực có cản quang. Propranolol nên được xem xét như là biện pháp điều trị chính của bướu máu hạ thanh môn do hiệu quả cao và ít tác dụng phụ.To describe the clinical, subclinical and treatment characteristics of pediatric patients from 1 moth to 12 months of age who were diagnosed with subglottic hemangioma at Respiratory Department 1 in Children Hospital 2 from January 2016 to February 2022. Subjects and method of study: 13 infants with diagnosed subglottic hemangioma from 1 month to 12 moths of age at Respiratory Department 1 in Children Hospital 2 from January 2016 To February 2022. Results: in 13 patients: female/male: 1,2/1
age of admission: at most 2 months (38,4%). The most common symtom onset time is 1- 2 months of age with stridor is the most clinical features (92,3%). There were 30.7% patients with sublottic hemangioma had skin hemangioma in in beard distribution: chin, madibular, preauricular. Subglottic hemangioma recorded in bronchoscopy caused obstruction in grade 2 and grade 3 (myer cotton classification). Chest contrast CT detected 57,1 % subglottic hemangioma, that reveals subglottic hemangioma can be missed in chest contrast CT. All patients respond well with propranolol alone with a mean dose of 2-3 mg/kg/day. Duration of treatment is more than 12 months and ending when patients were more than 15 moths of age. During the course of treatment, no serious side effects were noted. Until now, no cases of recurrence after discontinuation of treatment.

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