儿童复发性呼吸道乳头状瘤病肿瘤范围的量化评估

目的:探讨儿童复发性呼吸道乳头状瘤病(JO-RRP)肿瘤范围的量化评估方法的临床应用。方法:根据肿瘤范围大小分为3级分值(1分,2分及3分),评估68例JO-RRP患儿共238次手术,内镜下观察患儿22个呼吸和消化道的解剖亚区的肿瘤范围,计算积分;量化反映JO-RRP的分布特点及病情演变。结果:本组患儿肿瘤范围的积分在2~20分,7~14分占64.3%。全部患儿均有喉部受累,其中声带和室带是最常见的受累部位,鼻、咽、硬腭、气管、支气管、双肺和食管等受累较少见;随着手术治疗次数增多,肿瘤范围积分有下降趋势,与JO-RRP的临床特点相符。结论:以肿瘤范围为依据的量化评估法客观准确地反映了JO-RRP病变程度和临床疗效,是个科学而方便的方法,临床应用价值高,值得推广。

Quantitative evaluation of the focus range of juvenile onset recurrent respiratory papillomatosis

Objective:To investigate the clinical application of quantitative evaluation of the focus range of juvenile onset recurrent respiratory papillomatosis(JO-RRP).Method:Disease severity was scored as the sum of ratings of 1 (minimal),2 (moderate),or 3 (severe) for involvement of 22 areas of the respiratory tract and digestive tract. Sixty-eight cases with JO-RRP patients underwent 238 procedures were removed papillomas. A Storz laryngoscope was used to exposed and suspend the larynx, and an endoscope video system was used to display the pathological changes.Result:The score of these cases range from 2 to 20, most of them range from 7 to 14. Papillomas were found in the larynx in each case, vocal cords and false vocal cords were the most common places involved. Nose, pharynx, hard palate, lung or esophagus involved was seldom found. The score declined as the patients underwent more procedures. It is in accord with the clinical characteristic of JO-RRP.Conclusion:We concluded that our means of JO-RRP focus range quantitative evaluation could evaluate the severity and clinical curative effect objectively. It was a scientific and convenient way, and worth to be generalized.