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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。
Objective: To analyze the clinical features of children with juvenile recurrent respiratory papillomatosis (JORRP) and explore the timing of tracheotomy. Methods: Thirty-one children with JORRP undergoing tracheotomy were retrospectively analyzed. The clinical manifestations of JORRP including age of onset, site of tracheal dissemination, disease invasion and pathological changes were analyzed. Results: Thirty-one children with JORRP performed tracheotomy in 32 cases. The tracheal tube was removed in 3 cases at one month after surgery. There was no papilloma in the trachea, and the other 29 cases had different degree Papilloma growth; 20 cases of extubation in children, extubation 3 months or more no endobronchoma growth. Conclusion: Children with JORRP should avoid tracheotomy. Children who have tracheotomy should be extubated as early as possible to avoid the development of papilloma to the endotracheal tube. The timing of extubation may be selected when the growth of papilloma is small. Removal immediately after the operation, or plugging 24h after removal.