Shen Mengya, Xiao Yang, Ma Lijing, Wang Jun
Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Apr;35(4):312-315. doi: 10.13201/j.issn.2096-7993.2021.04.006.
To analyze the causes and related factors of postoperative complications of Juvenile-onset recurrent respiratory papillomatosis(JORRP). One hundred and seventy cases of JORRP who underwent surgical treatment in Beijing Tongren Hospital of Capital Medical University from 2017 to 2019 were followed up, and the types of complications, age of first operation, number and frequency of operations, and underwent tracheotomy or not were reviewed. According to the presence or absence of postoperative complications, the patients were divided into a complication group and a control group, and the differences between the two groups and related factors causing postoperative complications were compared. In the 170 cases, 75(44.12%) had postoperative complications, including 52(69.33%) cases of vocal cord adhesion, 37(49.33%) cases of lower airway diffusion, and 25(33.33%) cases of laryngeal stenosis in the complication group. The age of first operation was among 0.3-14 years old, and the total number of surgeries was 14.52(1-54) for each patient during the observation period, with an average annual number of 2.93(0.04-18.39). Compared with the control group, the complication group had 19.07±13.12 total surgeries, the control group had 10.97±9.41 surgeries(<0.01), annual surgeries ≥4 times(=0.034), postoperative complications after tracheotomy(=0.007), and underwent low temperature plasma radiofrequency ablation and photodynamic therapy were more likely to occur than those treated with CO2laser only(<0.01). The postoperative complications of JORRP include vocal cord adhesion, laryngotracheal stenosis, lower airway dissemination, etc. Multiple and frequent operations, tracheotomy, and different surgical methods are closely related to postoperative complications. The risk of postoperative complications may be increased when children are younger in age of initial operation and with more frequency of surgeries.
分析儿童复发性呼吸道乳头状瘤病(JORRP)术后并发症的原因及相关因素。对2017年至2019年在首都医科大学附属北京同仁医院接受手术治疗的170例JORRP患者进行随访,回顾并发症类型、首次手术年龄、手术次数及频率、是否行气管切开术等情况。根据术后有无并发症将患者分为并发症组和对照组,比较两组间差异及导致术后并发症的相关因素。170例患者中,75例(44.12%)发生术后并发症,并发症组中声带粘连52例(69.33%)、下气道播散37例(49.33%)、喉狭窄25例(33.33%)。首次手术年龄在0.3 - 14岁之间,观察期内每位患者手术总数为14.52(1 - 54)次,平均每年2.93(0.04 - 18.39)次。与对照组相比,并发症组手术总数为19.07±13.12次,对照组为10.97±9.41次(P<0.01),每年手术≥4次(P = 0.034),气管切开术后发生并发症(P = 0.007),且接受低温等离子体射频消融和光动力治疗的患者比仅接受CO₂激光治疗的患者更易发生并发症(P<0.01)。JORRP术后并发症包括声带粘连、喉气管狭窄、下气道播散等。手术次数多且频繁、气管切开术及不同手术方式与术后并发症密切相关。初次手术年龄较小及手术频率较高的儿童术后并发症风险可能增加。