婴儿毛息肉13例临床特征及诊治分析

Analysis on clinical characteristics,diagnosis and treatment of 13 cases of infant hairy polyp

目的探讨分析婴儿毛息肉的临床特征及诊治体会。方法回顾性分析河北省儿童医院自2010年1月至2019年9月收治的经病理确诊的13例婴儿毛息肉患儿的临床资料,其中男4例,女9例,男女比例为1∶2.25;年龄为出生3 h至1岁,中位年龄1月龄。13例患儿中12例因呼吸困难或喂养困难而被发现。所有患儿在全身麻醉下行鼻内镜辅助下鼻咽部肿物等离子切除术,术中发现肿物根蒂位于鼻咽侧壁8例;软腭与扁桃体腭咽弓上极交界处1例;舌根部1例;食道入口1例;鼻中隔2例,其中1例合并口腔毛息肉,位于两门齿之间。术中根蒂处创面以低温等离子射频消融并彻底止血。结果13例患儿手术过程顺利,术后临床症状消失,术后随访3个月至2年,12例患儿无复发,1例患儿术后2年纤维喉镜检查见右侧咽鼓管咽口肿物,考虑毛息肉复发,之后患儿失访。结论婴儿毛息肉为罕见病,主要表现为上呼吸道梗阻,早期诊断,尽早彻底手术是治疗该疾病的关键。

Objective:To explore and analyze the clinical characteristics,diagnosis and treatment of infant hairy polyp.Methods:A retrospective analysis was made on 13 cases of hairy polyp confirmed by pathology,who were admitted to the Children′s Hospital of Hebei Province from January 2010 to September 2019,including 4 males and 9 females,with a male-female ratio of 1∶2.25.The age ranged from 3 hours to 1 year,and the median age was 1 month.Twelve of the 13 children were found to have difficulty breathing or feeding.All the children received coblation resection under general anesthesia.The root pedicle of the mass was found in the lateral nasopharyngeal wall in 8 cases,in the junction of palatine and palatopharyngeal arch of tonsil and the tongue and esophageal entrance in 1 case,respectively.Nasal septum was found in 2 cases,including 1 case located between two incisors.The wound at the root pedicle was ablated and the bleeding was stopped completely.Results:Postoperative follow-up lasted from 3 months to 2 years,and there was no recurrence in 12 cases.Fibrolaryngoscope showed a mass of the right eustachian tube and pharyngeal mouth in 1 case 2 years after the surgery,which was considered recurrence of hairy polyps and lost after that.Conclusion:Hairy polyps in infants is a rare clinical disease,and its main symptom is upper respiratory tract obstruction.Early diagnosis and radical surgery are the key to the treatment of the disease.