低温等离子微创治疗在儿童咽喉部新生物中的应用  

The application of low-temperature plasma minimally invasive therapy in children with pharyngeal neoplasm

作　　者：张亚敏[1] 夏忠芳[1] ZHANG Yamin;XIA Zhongfang(Department of Otolaryngology,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan,430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)耳鼻咽喉科,武汉430016

出　　处：《临床耳鼻咽喉头颈外科杂志》2025年第2期141-146,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:分析儿童咽喉部新生物的临床特点,探讨低温等离子微创治疗在儿童咽喉部新生物中的临床疗效。方法:总结2016年1月—2023年12月武汉儿童医院耳鼻咽喉科收治的46例咽喉部新生物患儿的临床资料,其中男23例,女23例;年龄5 d~9岁4个月,中位年龄2岁2个月。对其临床特点、辅助检查及治疗情况进行分析。结果:46例患儿中,21例以喉喘鸣入院,7例因发现口咽部或头颈部肿物入院,5例以呼吸困难为首发症状,4例以睡眠打鼾为主要症状,3例声嘶,2例咽痛,2例吞咽不适,2例喂养困难。合并喉软化5例,鼾症4例,先天性心脏病4例,重症肺炎4例,心肌损害3例,多处畸形1例,另有1例为造血干细胞移植术后。所有患儿均行CT或MRI检查,26例行局部超声检查,39例行电子喉镜检查。共19例患儿术后转入ICU,均为咽喉囊肿患儿。所有患儿均行低温等离子微创手术,均经病理检查确诊,包括鼻咽部畸胎瘤1例,咽部非霍奇金淋巴瘤5例,口咽部横纹肌肉瘤1例,喉部血管周上皮样细胞肿瘤(PEComa)1例,咽喉部囊肿38例(悬雍垂2例,口咽2例,会厌谷7例,舌根19例,鳃裂囊肿2例,喉部6例)。结论:儿童期咽喉部占位易致气道梗阻,包括一些罕见或者恶性肿瘤,影像学检查及病理学检查可辅助诊断及尽早确诊,根据肿物性质不同,早发现早治疗,提高患儿生活质量及生存率。低温等离子射频消融术安全、微创、精准,且视野清晰,值得在儿童咽喉部新生物切除中推广。Objective Analyze the clinical features in children with pharyngeal neoplasm,and explore the clinical efficacy of low-temperature plasma minimally invasive treatment in children with pharyngeal neoplasm.Methods A total of 46 pediatric cases of pharyngeal neoplasms admitted to the Otolaryngology Department of Wuhan Children's Hospital from January 2016 to December 2023 were included.There were 23 males and 23 females,with admission ages ranging from 5 days to 9 years and 4 months,and a median age of 2 years and 2 months.The clinical manifestations,examinations,treatments,and outcomes were evaluated.Results Among the 46 pediatric patients,21 were admitted with throat wheezing,7 with masses in the oropharynx or head and neck,5 with dyspnea,4 with snoring during sleep as the main symptom,3 with hoarseness,2 with sore throat,2 with swallowing discomfort,and 2 with difficulty feeding as the first symptom.Comorbidities included 5 cases of combined laryngomalacia,4 of snoring,4 of congenital heart disease,4 of severe pneumonia,3 of myocardial damage,1 of multiple deformities,and 1 after hematopoietic stem cell transplantation.All patients underwent CT or MRI examination,with 26 cases undergoing local ultrasound examination and 39 undergoing electronic laryngoscopy examination.A total of 19 patients were transferred to the ICU after surgery,all of whom were patients with pharyngeal cysts.All patients underwent low-temperature plasma minimally invasive surgery,and all patients were diagnosed through pathological examination,including 1 case of nasopharyngeal teratoma,5 of pharyngeal non-Hodgkin's lymphoma,1 of oropharyngeal rhabdomyosarcoma,1 of laryngeal perivascular epithelioid cell tumor(PEComa),and 38 of pharyngeal cysts(2 cases of uvula,2 of oropharynx,7 of epiglottic valley,19 of tongue base,2 of branchial cleft cyst,and 6 of throat).Conclusion Pharyngeal neoplasms in children are prone to upper airway obstruction,including some rare or malignant tumors.Imaging and pathological diagnosis can assist in early diagnosis

关 键 词：咽喉部新生物 低温等离子 儿童 

分 类 号：R766.8[医药卫生—耳鼻咽喉科]