[1]王洪琴,黄敏,胡彬雅,等.儿童喉乳头状瘤临床特征及手术疗效分析[J].临床小儿外科杂志,2023,22(10):966-970.[doi:10.3760/cma.j.cn101785-202301017-012]
　Wang Hongqin,Huang Min,Hu Binya,et al.Clinical features and operative efficacies of juvenile onset laryngeal papilloma[J].Journal of Clinical Pediatric Surgery,2023,22(10):966-970.[doi:10.3760/cma.j.cn101785-202301017-012]
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儿童喉乳头状瘤临床特征及手术疗效分析

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第22卷 期数: 2023年10 页码: 966-970 栏目: 论著 出版日期: 2023-10-28
Title:
Clinical features and operative efficacies of juvenile onset laryngeal papilloma
作者:
王洪琴1; 2;  黄敏2;  胡彬雅2;  李赟2;  谢骏2;  谢丽华2;  刘光亮2;  赵斯君2
1 南华大学儿科学院, 衡阳 421200;
2 湖南省儿童医院耳鼻咽喉头颈外科, 长沙 410007
Author(s):
Wang Hongqin1; 2;  Huang Min2;  Hu Binya2;  Li Yun2;  Xie Jun2;  Xie Lihua2;  Liu Guangliang2;  Zhao Sijun2
1 College of Pediatrics, University of South China, Hengyang 421200, China;
2 Department of Otolaryngology, Head & Neck Surgery, Hunan Children’s Hospital, Changsha 410007, China
关键词:
喉; 乳头状瘤; 病理生理学; 外科手术; 治疗结果; 儿童
Keywords:
Larynx; Papilloma;  Physiopathology; Surgical Procedures;  Operative; Treatment Outcome; Child
DOI:
10.3760/cma.j.cn101785-202301017-012
摘要:
目的 探讨儿童喉乳头状瘤的临床特征、手术方式及疗效。方法 以湖南省儿童医院耳鼻咽喉头颈外科2013年1月至2022年10月收治的63例喉乳头状瘤患儿作为研究对象,收集患儿一般资料、首次发病情况及电子纤维喉镜检查结果等分析其临床特征。收集上述患儿中55例首诊于本院并行手术治疗的患儿疗效情况。结果 63例患儿发病中位年龄为2岁1个月,53例(53/63,84.1%)无明显诱因出现临床症状,首发症状均为声嘶,其中合并气促11例(11/63,17.5%)、喉鸣14例(14/63,22.2%)、呼吸困难6例(6/63,9.5%);术后病理诊断均为喉鳞状上皮乳头状瘤,其中17例(17/63,27.0%)行免疫组化检查,7例(7/63,11.1%)存在人乳头状瘤病毒(human papilloma virus,HPV)感染。55例首诊于本院并确诊的患儿均于全身麻醉下行支撑喉镜喉乳头状瘤摘除术,其中53例(53/55,96.4%)采用冷器械摘除乳头状瘤,2例(2/55,3.6%)使用电动吸割器及冷器械;采用0.1%肾上腺素止血22例(22/55,40.0%),电刀灼烧肿瘤基底部止血31例(31/55,56.4%),双极电凝止血2例(2/55,3.6%);术后存在声带瘢痕1例(1/55,1.8%),声带粘连4例(4/55,7.3%),喉狭窄2例(2/55,3.6%);术后复发37例(37/55,67.3%)。结论 喉乳头状瘤首次发病以1~3岁常见;首发症状为声嘶,可合并气促、喉鸣、呼吸困难等;术后可并发声带瘢痕、声带粘连、喉狭窄等;与以往文献报道相比,冷器械摘除乳头状瘤复发率较高,术后并发症相对较少。
Abstract:
Objective To explore the clinical features,surgical approaches and curative efficacies of children with juvenile onset laryngeal papilloma over the last decade.Methods From January 2013 to October 2022,63 children hospitalized with laryngeal papilloma at Hunan Children’s Hospital were recruited as research subjects.The relevant clinical data were retrospectively reviewed,including general profiles,initial presentations and the results of electronic fiber laryngoscopy.The outcomes were recorded for 55 children initially operated.Results The median average age of onset was 25 months.Fifty-three cases (n=53,84.1%) had no obvious cause of clinical symptoms.The initial symptom of 63 cases (100%) was hoarseness associated with dyspnea (n=11,17.5%),throat ringing (n=14,22.2%) and shortness of breath (n=6,9.5%).The postoperative pathological diagnosis was laryngeal squamous epithelial papilloma.seventeen cases (n=17,27.0%) underwent immunohistochemical examination and 7 cases (n=7,11.1%) were infected with human papilloma virus.All lesions of laryngeal papilloma were removed under general anesthesia with laryngoscopic assistance.Removal was completed by cold instruments (n=53,96.4%) and electric suction and cold instruments (n=2,3.6%).Interventions included 0.1% adrenaline for hemostasis (n=22,40.0%),electroscalpel for hemostasis (n=31,56.4%) and bipolar electrocoagulation (n=2,3.6%).There were vocal cord scar (n=1,1.8%),vocal cord adhesion (n=4,7.3%) and laryngeal stenosis (n=2,3.6%).Postoperative recurrence occurred in 37 cases (37/55,67.3%).Conclusion Age of initial occurrence of laryngeal papilloma is usually 1-3 years.The presenting symptom is hoarseness associated with throat ringing and dyspnea.Common postoperative complications include vocal cord scar,vocal cord adhesion and laryngeal stenosis.As compared with previous reports,cold instrument resection of papilloma has a higher recurrence rate with fewer postoperative complications.

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备注/Memo

收稿日期:2023-1-29。
通讯作者:赵斯君,Email:zhaosj3991@sohoo.com

更新日期/Last Update: 1900-01-01