经支气管镜介入诊疗在儿童原发性气道肿瘤中的应用  

Bronchoscopy interventional diagnosis and treatment of primary airway tumors in children:a clinical analysis

作　　者：张继燕 张喜 刘腾 肖政辉 黄建宝 张新萍 张瑾 段效军 Zhang Jiyan;Zhang Xi;Liu Teng;Xiao Zhenghui;Huang Jianbao;Zhang Xinping;Zhang Jin;Duan Xiaojun(Department of Respiratory,The Affiliated Children’s Hospital of Xiangya School of Medicine,Central South University(Hunan Children’s Hospital),Changsha 410007,China;Department of General Surgery,Hunan Chest Hospital,Changsha 410000,China;Emergency Center,The Affiliated Children’s Hospital of Xiangya School of Medicine,Central South University(Hunan Children’s Hospital),Changsha 410007,China)

机构地区：[1]中南大学湘雅医学院附属儿童医院湖南省儿童医院呼吸内科,长沙410007 [2]湖南省胸科医院普外科,长沙410000 [3]中南大学湘雅医学院附属儿童医院湖南省儿童医院急救中心,长沙410007

出　　处：《临床小儿外科杂志》2025年第3期265-270,共6页Journal of Clinical Pediatric Surgery

基　　金：儿童急救医学湖南省重点实验室(2018TP1028);湖南省卫生健康委科研计划课题(202206013971)。

摘　　要：目的总结儿童原发性气道肿瘤的临床特征,探讨支气管镜介入诊疗在儿童原发性气道肿瘤中应用的有效性和安全性。方法本研究为回顾性研究,以2019年1月至2023年9月在湖南省儿童医院接受住院治疗的10例原发性气道肿瘤患儿为研究对象,收集患儿临床症状、影像、病理、支气管镜介入诊疗方法及转归资料。结果男6例、女4例,起病年龄1个月16天至12岁5个月;病程15~180天;临床症状:咳嗽7例,声嘶4例,喉鸣3例,喘息3例,发热2例,咯血1例;肿瘤部位:喉部6例(声门上及会厌部4例,声门下2例),气管及支气管4例(气管1例,左主支气管1例,右主支气管1例,右中叶支气管1例);肿瘤性质:声门下血管瘤2例,喉乳头状瘤4例,腺瘤1例,粘液表皮样癌2例,炎性肌纤维母细胞瘤1例。10例均经支气管镜诊治,2例声门下血管瘤经口服普萘洛尔好转,4例喉乳头状瘤经多次手术治疗、1例腺瘤支气管镜介入治疗后随访30个月无反复,2例黏液表皮样癌和1例炎性肌纤维母细胞瘤患儿支气管镜下活检及清除部分肿块后行外科根治手术治疗,3例患儿分别随访18个月、30个月和36个月,术中、术后均未出现大出血、气胸等严重并发症。结论儿童原发性气道肿瘤症状缺乏特异性,易误诊及漏诊;支气管镜介入不仅可获取病理活检明确诊断,亦可为气道内恶性肿瘤根治手术创造条件。Objective To summarize the clinical characteristics of primary airway tumors in children and to evaluate the effectiveness and safety of bronchoscopic interventional diagnosis and treatment for these tumors.Methods This retrospective study included 10 pediatric patients diagnosed with primary airway tumors who were hospitalized at Hunan Children’s Hospital between January 2019 and September 2023.Clinical symptoms,imaging findings,pathological results,bronchoscopic interventional treatment methods,and patient outcomes were collected and analyzed.Results Among the 10 patients,there were 6 males and 4 females,with an onset age ranging from 1 month and 16 days to 12 years and 5 months.The duration of symptoms varied from 15 to 180 days.Clinical symptoms included cough(n=7),hoarseness(n=4),stridor(n=3),wheezing(n=3),fever(n=2),and hemoptysis(n=1).The tumor locations were:larynx(n=6,including 4 in supraglottic and epiglottic regions,and 2 in the subglottic region),trachea and bronchi(n=4,including 1 in the trachea,1 in the left main bronchus,1 in the right main bronchus,and 1 in the right middle lobe bronchus).Tumor pathology included subglottic hemangioma(n=2),laryngeal papilloma(n=4),adenoma(n=1),mucoepidermoid carcinoma(n=2),and inflammatory myofibroblastic tumor(n=1).All patients underwent bronchoscopic diagnosis and treatment.The 2 cases of subglottic hemangioma showed improvement with oral propranolol therapy.The 4 cases of laryngeal papilloma required multiple surgical treatments.One patient with adenoma underwent bronchoscopic intervention and remained recurrence-free during 30 months of follow-up.The 2 cases of mucoepidermoid carcinoma and 1 case of inflammatory myofibroblastic biopsy and partial tumor resection,followed by surgical resection.The three patients who underwent surgical treatment were followed up for 18,30,and 36 months,respectively,with no severe intraoperative or postoperative complications such as massive hemorrhage and pneumothorax.Conclusions Primary airway tumors in children present with

关 键 词：儿童 气道肿瘤 支气管镜 介入治疗 

分 类 号：R734.1[医药卫生—肿瘤]