Objective: To observe the clinical course of children with juvenile-onset recurrent respiratory papillomatosis (JORRP) until 14 years old. Methods: The clinical data of one hundred and twenty cases treated between Januray 1, 2002 and September 30, 2017 in Beijing Tongren Hospital were analyzed retrospectively. Excluding the deaths and the lost, patients who could be ≥ 5 years without recurrence, were defined as the cured group, and < 5 years with recurrence defined as the recurrent group. Furthermore, using statistical methods to analyze the differences of the age of initial operation, total number of operations, invasive lesion, HPV infection, tracheotomy, airway dissemination after tracheotomy and time of tube wear between the two groups. Results: One hundred and three cases were followed up, except for the six deaths.Numbers of operations in eight cases were ≤2, and ≥3 in eighty nine cases.Peak of the primary surgical age were about 4.5 years old, while the self-healing trend occurred at nine years old. In the cured group, forty three cases were cured, with a curative rate of 41.7% (43/103), and there were all fifty four survivors in the recurrent group.The total number of operations, invasive cases, HPV positive cases and the G score of hoarseness in the recurrent group were higher than those in the cured group (F=13.02, χ(2)=13.04, χ(2)=17.37, Z=-4.59, P<0.05). The number of tracheal dissemination caused by tracheotomy in the recurrent group (66.7%, 27.8%)was more than that in the cured group (χ(2)=16.01, P<0.05). Compared with the time of wearing a tracheostomy tube in cured group, the recurrent group was longer ((3.4±3.1) years vs (8.3±6.7) years, χ(2)=7.19, P<0.05). Conclusions: 41.7% of the patients had no relapse for at least five years.There exsisted differences between the cured and recurrent group in the following aspects: the total numbers of surgery, the agression of the lesions, tracheal intratracheal dissemination after tracheotomy, the time of tracheotomy, the HPV typing and the G grading of hoarseness.
目的： 对幼年型复发性呼吸道乳头状瘤病(juvenile－onset recurrent respiratory papillomatosis，JORRP)患儿长期随访至其满14岁，观察其远期疗效。 方法： 回顾性分析2002年1月1日至2017年9月30日在首都医科大学附属北京同仁医院耳鼻咽喉科住院治疗的120例JORRP患儿术后的临床病例资料，并进行长期随访。排除死亡及失访患儿，将≥5年未复发者定义为治愈组，<5年复发者定义为复发组，采用SPSS 21.0软件统计分析两组间初次手术年龄、个人总手术次数、病变侵袭性、人乳头状瘤病毒(HPV)感染情况、气管切开、气管切开后气道播散及戴管时间的差异。 结果： 最终共随访到103例，其中6例死亡。初次手术年龄高峰约4.5岁，约9岁出现自愈倾向。治愈组43例，治愈率41.7%(43/103)；复发率58.3%(60/103)。复发组的个人总手术次数、病变侵袭率、人乳头瘤病毒(HPV)阳性率、声音嘶哑G评分均较治愈组高(F＝13.02，χ(2)＝13.04，χ(2)＝17.37，Z＝－4.59，P值均<0.05)。复发组气管切开后所致气管内播散比例较治愈组高[66.7%(14/21)比27.8%(5/18)，χ(2)＝16.01，P<0.05]；与治愈组戴管时间比较，复发组气管切开后戴管时间更长[(3.4±3.1)年比(8.3±6.7)年，χ(2)＝7.19，P<0.05)]。 结论： 41.7%患者至少5年未复发。治愈组与复发组JORRP患儿发病在个人总手术次数、病变侵袭情况、气管切开后瘤体气管内播散、气管切开后戴管时间、HPV分型、声音嘶哑G分级评估等方面存在差异。.
Keywords: Adult; Children; Papilloma; Recurrent; Respiratory tract diseases.