新生儿气管食管瘘（TEF, TOF）丨医学英语视听学习

Tracheoesophageal Fistula (TEF, TOF)

气管食管瘘（TEF, TOF）

A tracheoesophageal fistula is a birth defect in which the esophagus has an abnormal connection to the trachea. 

气管食管瘘是食管和气管异常连接的一种先天性缺陷。

The esophagus is the tube that food passes through from the mouth to the stomach, and the trachea is the windpipe that air passes through from the mouth and nose to the lungs. The trachea forms during the sixth week of pregnancy.  

食管是食物自口腔进入胃所通过的管道，气管是空气自口和鼻进入肺所通过的气管。气管形成于妊娠第六周。

Here, you can see the tube that will eventually form all the organs of the digestive system. The trachea and lungs grow from the part of the digestive tube that will eventually become the esophagus.

在这里，我们可以看到最终形成消化系统所有器官的管道。消化管最终形成食道，而气管和肺则是自原始消化管分化而来。

For unknown reasons, the esophagus and trachea may grow and separate abnormally during this time. The esophagus may end in a blind pouch with missing gaps and be abnormally narrow. 

由于未知原因，分化期间，食管和气管可能异常生长和分离。食管可能形成盲端，出现漏隙，食管异常狭窄。

This absence or narrowing of a natural body passageway is called atresia. The esophagus and trachea may also have an abnormal connection called a tracheoesophageal fistula.

这种人体自然通道缺失或狭窄称为闭锁。食管和气管也可能异常连接，形成气管食管瘘。

Here, we see the most common type of tracheoesophageal fistula in a newborn infant. The upper esophagus ends in a blind pouch, and the lower esophagus connects to the trachea.  

例如，最常见的新生儿气管食管瘘。食道上段为盲端，食道下段与气管相连。

This is a serious problem because stomach contents can travel up the esophagus and pass through the fistula into the trachea and lungs. The fistula can also cause difficulty breathing for the newborn since air can now bypass the lungs and enter the stomach.

这种疾病非常严重，因为胃内容物可沿食管上行，并通过瘘道进入气管和肺。瘘道也可导致新生儿呼吸困难，因为此时空气可绕过肺，进入胃。

Before the tracheoesophageal fistula repair procedure, an intravenous line will be started. The baby may be given antibiotics through the IV to decrease the chance of infection. The baby will be given general anesthesia which will put the baby to sleep for the entire operation. A breathing tube will be inserted through the mouth and down the throat to help the baby breathe during the operation.  

行气管食管瘘修复术前，开始给患儿静脉输注抗生素，来降低感染风险。患儿将接受全身麻醉，确保整个手术期间保持睡眠状态。医生经患儿口腔，沿喉下行插入呼吸管，帮助患儿术中呼吸；

The surgeon will make an incision in the baby’s chest, usually on the right side. Through the incision, the surgeon will gently move the lungs aside to view the trachea and the esophagus.

在患儿胸部，通常是右侧胸部做一个切口；通过切口，轻轻将肺移到一侧，观察气管和食管。

After identifying the tracheoesophageal fistula, the surgeon will slowly close the fistula’s connection to the trachea with sutures, then cut the connection away from the trachea. The fistula’s connection to the esophagus will also be cut, and the fistula will be removed.  

确定气管食管瘘后，医生将使用缝合线慢慢缝合瘘道与气管的连接，然后切断二者之间的连接，以及瘘道与食管的连接，切除瘘道。

Next, the surgeon will make an incision at the end of the upper esophagus to open it. Then, the upper and lower esophagus will be connected with sutures. 

接着，医生在食道上段末端做切口，打开食道；然后使用缝线连接食道上、下段。

Finally, the surgeon will insert a surgical drain in the chest and close the incision with sutures.

最后，在患儿胸部插入手术引流管，使用缝线缝合切口。

After the procedure, the baby will continue to use the breathing tube until they’ve healed enough to breathe on their own. The baby will be taken to the neonatal intensive care unit for monitoring. Pain medication will be given. The baby may continue to receive antibiotics through the IV. 

术后，患儿将继续使用呼吸管，直至能够自主呼吸。医生会将患儿转至新生儿重症监护室进行监护；给予止痛药止痛；继续静脉输注抗生素消炎。

Babies are released from the hospital when they’re able to eat enough to maintain their weight, which may be after two weeks or longer.

两周或更常时间后，当患儿能够摄入足够的食物维持体重时，即可出院。