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青少年复发性呼吸道乳头瘤病患者的气管切开术依赖时间。

The duration of tracheostomy dependence in patients with juvenile-onset recurrent respiratory papillomatosis.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Ministry of Education, Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing, China.

出版信息

Acta Otolaryngol. 2022 Jul-Aug;142(7-8):610-615. doi: 10.1080/00016489.2022.2098532. Epub 2022 Jul 25.

DOI:10.1080/00016489.2022.2098532
PMID:35876477
Abstract

BACKGROUND

Tracheostomy is a vital therapy for juvenile-onset recurrent respiratory papillomatosis (JORRP) to maintain an adequate airway in an emergency, yet the relationship between cannulation duration and prognosis has not been extensively explored.

OBJECTIVES

To investigate the predictive influence of the duration of tracheostomy dependence on JORRP remission.

MATERIALS AND METHODS

A retrospective review of JORRP patients ( = 77) with tracheostomy treated in Beijing Tongren Hospital was performed.

RESULTS

The rate of decannulation was 72.7%. After decannulation for one year, the percentage of distal spread fell from 42.9 to 30.4%. Twenty-six of 77 patients (33.8%) had remission of their disease, 40 (51.9%) continued to have active disease while 11 (14.3%) died during follow-up. The cannulation duration was positively correlated with the overall duration of this disease ( = 0.6). The cut-off point of 34.9 months for cannulation duration indicated the highest predictive value of remission. Duration of cannulation >34.9 months (OR = 0.33) and distal spread (OR = 0.29) decreased odds of remission.

CONCLUSION

The study demonstrates that the time span before decannulation indicates the severity of disease and cannulation aggravates the distal spread. Patients with cannulation duration ≤ 34.9 months after tracheostomy are prone to possess a relatively pleasant prognosis.

摘要

背景

气管切开术是青少年复发性呼吸道乳头状瘤病(JORRP)的重要治疗方法,可在紧急情况下维持气道通畅,但气管切开术依赖时间与预后之间的关系尚未得到广泛探讨。

目的

探讨气管切开术依赖时间对 JORRP 缓解的预测影响。

材料和方法

对在北京同仁医院接受气管切开术治疗的 JORRP 患者(n=77)进行回顾性研究。

结果

拔管率为 72.7%。拔管 1 年后,远端扩散率从 42.9%下降至 30.4%。77 例患者中有 26 例(33.8%)疾病缓解,40 例(51.9%)疾病持续活跃,11 例(14.3%)在随访期间死亡。气管切开术依赖时间与疾病总病程呈正相关(r=0.6)。气管切开术依赖时间的截断值为 34.9 个月,对缓解的预测价值最高。气管切开术依赖时间>34.9 个月(OR=0.33)和远端扩散(OR=0.29)降低了缓解的可能性。

结论

该研究表明,拔管前的时间跨度表明疾病的严重程度,且气管切开术加重了远端扩散。气管切开术后 34.9 个月内拔管的患者预后较好。

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