幼年型复发性呼吸道乳头状瘤气管切开的临床研究

目的：分析幼年型复发性呼吸道乳头状瘤（JORRP）气管切开患儿的临床特征，探讨气管切开的拔管时机。方法：对31例接受气管切开术的JORRP患儿进行回顾性分析，分析JORRP的发病年龄、气管内播散的部位、疾病侵袭性、病变生长方式等临床表现。结果：31例JORRP患儿共行气管切开术32例次，3例次为手术后1个月拔除气管套管，气管内无乳头状瘤生长，其余29例次气管内均有不同程度的乳头状瘤生长；20例次拔管患儿中，拔管3个月以上者气管内未见乳头状瘤生长。结论：JORRP患儿应尽量避免气管切开，已行气管切开的患儿应及早拔管，避免乳头状瘤向气管内发展，拔管时机可选择在乳头状瘤生长较少时，可于手术结束后即刻拔除，或术后堵管24h后拔除。

Clinical study of tracheotomied children with juvenile onset recurrent respiratory papillomatosis

OBJECTIVE: To analysis the clinical characteristics of tracheotomied children with Juvenile-onset recurrent respiratory papillomatosis (JORRP) and to discuss the time of decannulation. METHOD: Thirty-one children with JORRP, who underwent tracheotomy and treated with CO2 laser in Otorhinolaryngololgy department of Tongren Hospital between 1993 and 2005, were reviewed in this essay. We analysis the age, the site of intratracheal papilloma, invasion fashion of lesion, et al. RESULT: Thirty-one tracheotomied children underwent 32 tracheotomy, 20 cases was decannulated. Among the 32 tracheotomied cases, three cases were decannulated in 1 month post operation and the intratracheal lesions were not found. There were presented intratracheal lesions in 29 cases. Intratracheal lesions were not presented in 20 cases after three months of decannulation. CONCLUSION: The tracheotomy should strive to be avoided to JORRP patients. If a JORRP patient was underwent tracheotomy, he should be decannulated as early as possible. The time of decannulation was performed in the operation or post operation when the intratracheal lesions was less.