儿童颈段原发性气管恶性肿瘤的临床表现和治疗  

Study on clinical manifestations and treatment of primary cervical tracheal malignant tumor of children

作　　者：李友忠[1] 卢永德[1] 彭安全[1] 任基浩[1] 杨新明[1] 

机构地区：[1]中南大学湘雅二院耳鼻咽喉头颈外科,长沙410011

出　　处：《临床耳鼻咽喉头颈外科杂志》2009年第15期697-699,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨儿童颈段原发性气管恶性肿瘤的临床表现和治疗方法。方法:对1998年以来经纤维喉镜、CT扫描、组织病理学诊断的5例原发性气管恶性肿瘤患儿的诊治进行回顾性分析。4例患儿于肿瘤下方行紧急气管切开,1例气管插管后气管切开,用气管镜和鼻内镜联合摘除气管内肿瘤;术后4例接受放疗,1例激光加放疗。结果:5例患儿随访3～8年无复发。结论:儿童气管恶性肿瘤,影像检查是有效的诊断手段,就诊时病情危重,宜行低位气管切开,逆行鼻内镜及硬管气管镜联合下彻底摘除肿瘤,术后辅以放疗可获得良好效果。儿童患者一般不宜行有创的气管壁切除术。Objective：To study the clinical manifestations and treatment of the primary cervical tracheal malignant tumor of children. Method：Five cases diagnosed as primary tracheal malignant tumor with fibrolaryngoscopy, CT scan and pathology were retrospectively analyzed and reviewed. Extraction of malignant tumor was performed with tracheoscope and nasal endoscope after emergent tracheotomy below the tumor in 4 cases, and tracheotomy after intubation in 1 case. After operation, 4 children received radiotherapy, and 1 case received laser therapy add radiotherapy. Result：Five cases were followed up for three to eight years, and no recurrence was found. Conclusion：There was no specific manifestation in early tracheal malignant tumor, but it was critical and emergent during symptoms appear. Imaging examination was a very invaluable dignosis method. Optimal and effective therapeutic protocol is tracheostomy under local anesthesia to keep upper airway patency followed by surgical extraction and radiotherapy. It was not appropriate to have tracheal wall resection for children.

关 键 词：儿童 气管肿瘤 鼻内镜 气管镜 

分 类 号：R734.1[医药卫生—肿瘤]