Analysis on clinical data of 176 pediatric patients with central airway stenosis

TANG Sixiang; WU Shangzhi; LI Hongwei; LIN Junxing; XU Qingyun; LIN Yuneng; XU Jiaxing; LONG Jitong; HUANG Zhanhang; CHEN Dehui

doi:10.3969/j.issn.1674-3806.2025.07.12

Abstract：Objective To analyze the clinical data of 176 pediatric patients with central airway stenosis and to summarize the etiological distribution and clinical features of central airway stenosis in the pediatric patients,providing reference for the diagnosis and treatment of central airway stenosis in pediatric patients.Methods The clinical data of 176 pediatric patients with central airway stenosis who were admitted to the First Affiliated Hospital of Guangzhou Medical University from January 2018 to December 2023 were retrospectively analyzed.The clinical data included the pediatric patients' general data,causes and locations of central airway stenosis,results of the first pulmonary function test,and results of computed tomography(CT)and bronchoscopy during their hospitalization,and results of blood gas analysis and clinical manifestation at admission.Results Among the 176 pediatric patients with central airway stenosis,120 pediatric patients were male(68.18％)and 56 pediatric patients were female(31.82％).The median age was 17 months.The main causes of congenital central airway stenosis(25.00％,44/176)were congenital pulmonary airway malformation(18.18％,32/176),among them,the pediatric patients aged 12-35 months accounted for the highest proportion(37.50％,12/32).The main causes of acquired central airway stenosis(75.00％,132/176)were tracheal intubation or tracheotomy(35.23％,62/176),airway foreign body(17.05％,30/176)and airway infection(15.91％,28/176)in sequence,among them,the proportion of the pediatric patients aged ≥36 months who underwent tracheal intubation or tracheotomy was the highest(43.55％,27/62).The subglottic stenosis(39.20％,69/176)and the stenosis in the right main bronchus or the right middle bronchus,and the left main bronchus(37.50％,66/176)accounted for a relatively high proportion.The main cause of subglottic stenosis was tracheal intubation or tracheotomy(78.26％,54/69).Pulmonary ventilation function test was performed on 7 pediatric patients,and the results indicated obstructive ventilation dysfunction in varying degrees.Blood gas analysis was performed on 109 pediatric patients,and the results showed that partial pressure of oxygen(PaO2)decreased in 44 cases(40.37％),partial pressure of carbon dioxide(PaCO2)increased in 35 cases(32.11％),pH decreased in 29 cases(26.61％),actual bicarbonate ion concentration increased in 38 cases(34.86％),and base excess increased in 22 cases(20.18％).The main clinical manifestations of the pediatric patients were cough,wheezing,shortness of breath and three-concave sign.The detection rates of central airway stenosis by using CT and using bronchoscopy were 80.46％and 100.00％,respectively.Conclusion The proportions of the pediatric patients with different etiologies in different age groups and the main causes of each stenosis location in the central airway are different.The main causes of acquired central airway stenosis are tracheal intubation or tracheotomy,airway foreign body and airway infection in sequence.