XXXIII. Laryngitis and Tracheobronchitis in Children: Special Reference to Non-Diphtheritic Infections
XXXIII. Laryngitis and Tracheobronchitis in Children: Special Reference to Non-Diphtheritic Infections
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三十三．
DOI：
10.1177/000348943204100210
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发表时间：
1932
期刊：
影响因子：
--
通讯作者：
T. R. Gittins
中科院分区：
文献类型：
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作者：
T. R. Gittins
婴幼儿的喉部和气管支气管感染通常是非常严重的情况。空气通道的机械阻塞有时比感染本身增加了更大的危险。多年来，白喉被普遍认为是几乎所有传染性喉部呼吸困难病例的罪魁祸首。1920年，我们第一次意识到，有一些喉部、气管和支气管的非白喉感染，其发病和症状与白喉相似，但抗毒素没有缓解作用，导管下方的机械阻塞显然比真正的白喉更麻烦。我们的前三个病例。发生在1920年和1921年，最终以死亡告终。随着这些非白喉感染的不断出现，气管切开术后采取更积极的措施保持气管和支气管无分泌物和半固体塞，死亡率下降。然而，尽管不断努力消除增加的困难，但它始终高于真正的白喉病例。1926年，在美国喉、鼻、耳学会成立之前，我讨论过同样的问题；回顾了十二年的美国文学；引自14个参考文献；在我们的私人诊所报告了十四起案件。当时我强调，并没有要求人们注意一种罕见的或新的疾病，但有理由相信，许多非白喉病例被当作白喉来处理，并在死亡率和卫生统计中被归类为白喉。
Laryngeal and tracheobronchial infections in infants and young children are often very serious conditions. The mechanical obstruction of the air passages adds a much greater hazard at times than does the infection itself. For many years diphtheria has been quite universally blamed for practically all cases of laryngeal dyspnea of infectious origin. In 1920 we realized for the first time that there were nondiphtheritic infections of the larynx, trachea and bronchi in which the onset and symptoms simulated diphtheria, but in which antitoxin gave no relief and mechanical obstruction below the canula was decidedly more troublesome than in true diphtheria. Our first three cases of this disease. occurring in 1920 and 1921, terminated fatally. As these nondiphtheritic infections continued to appear, more active measures were taken to keep the trachea and bronchi free from discharge and semisolid plugs after tracheotomy, and our mortality decreased. It has remained consistently higher, however, than in cases of true diphtheria, despite continuous efforts to combat the added difficulties. In 1926, before the American Laryngological, Rhinological and Otological Society, I discussed this same subject; reviewed the American literature for twelve years; quoted from some fourteen references; and reported fourteen cases from our own private practice. At that time I emphasized that attention was not being called to a rare or new condition, but there was reason to believe that many of the nondiphtheritic cases were being handled as diphtheria, and classified as such in mortality and health statistics.