新生儿及婴幼儿鼻咽部畸胎瘤的临床特点及诊治探讨

发布时间：2018-03-27 07:03

本文选题：畸胎瘤　切入点：新生儿　出处：《临床耳鼻咽喉头颈外科杂志》2015年12期

【摘要】：目的:探讨新生儿及婴幼儿鼻咽部畸胎瘤的临床特点及治疗方法,以减少误诊误治。方法:回顾性研究11例新生儿及婴幼儿鼻咽部畸胎瘤患儿的资料,总结其临床特点。鼻咽镜、CT或MRI等术前常规检查后,在全身麻醉气管内插管下,8例行低温等离子射频消融手术,3例行动力系统常规手术切除。结果:11例患儿新生物均完全切除,手术时间5~15min,术中出血1~5ml,术后患儿无明显鼻塞、出血、进食鼻咽反流或呼吸困难等并发症。术后每2周复查电子纤维鼻咽镜1次,均可见创面有白膜及纤维蛋白样渗出物,约3周后白膜大部分脱落,随访3个月,白膜均完全脱落,经鼻呼吸顺畅,打鼾及张口呼吸症状缓解,鼻咽部黏膜上皮化良好。随访10个月~9年无复发。结论:在鉴别婴幼儿呼吸困难,特别是有上呼吸道梗阻和呛奶症状时,应考虑鼻咽部畸胎瘤;鼻内镜下低温等离子射频消融手术具有时间短,术中操控精准、出血少、术野清晰,术后反应轻、痛苦小、复发率低等优点,为临床提供了一种新的治疗手段。
[Abstract]:Objective: to investigate the clinical features and treatment of nasopharyngeal teratoma in neonates and infants in order to reduce misdiagnosis and mistreatment. Methods: the data of 11 neonates and infants with nasopharyngeal teratoma were retrospectively studied. The clinical features were summarized. After routine examination of nasopharyngoscope CT or MRI before operation, 8 patients underwent low temperature plasma radiofrequency ablation and 3 patients underwent conventional dynamic system resection under endotracheal intubation under general anesthesia. The operative time was 5 ~ 15 minutes, the intraoperative bleeding was 1 ~ 5 ml, and there were no complications such as nasal congestion, bleeding, feeding nasopharyngeal reflux or dyspnea. The results showed that there were white membrane and fibrin like exudates in the wounds every 2 weeks. After about 3 weeks, most of the white membrane fell off, followed up for 3 months, the white membrane completely fell off, the breath was smooth through the nose, and the symptoms of snoring and mouth opening were relieved. The nasopharyngeal mucosal epithelization was good and no recurrence occurred during the follow-up period of 10 months to 9 years. Conclusion: nasopharyngeal teratoma should be considered when differentiating infants with dyspnea, especially with upper respiratory obstruction and milk choking. Low temperature plasma radiofrequency ablation under nasal endoscope has the advantages of short time, accurate manipulation, less bleeding, clear surgical field, light postoperative reaction, less pain and low recurrence rate, which provides a new method for clinical treatment.
【作者单位】：武汉市妇女儿童医疗保健中心耳鼻咽喉科;
【基金】：武汉市卫生局临床医学科研项目(No:WX14A07)
【分类号】：R739.63

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