ABSTRACT
Objective:To study the strategies in the diagnosis and treatment of pancreatic tumors in children.Methods:The clinical data of 18 children with pancreatic tumor managed at the Children's Hospital Affiliated to Chongqing Medical University from March 2015 to September 2020 were retrospectively studied. There were 8 males and 10 females, age ranged from 3 months to 14 years and 11 months, with a median age of 8 years and 2 months. Clinical data including age, gender, pathological data, surgical methods, chemotherapy, tumor location and treatment outcomes were collected. Follow-up was conducted by outpatient visits and by telephone.Results:Abdominal ultrasound, enhanced CT and/or MRI examinations were performed on all these patients, with findings of either a cystic or solid lesion of pancreas. All patients were treated by laparotomy under endotracheal intubation and general anesthesia. The operations were all completed successfully. Among the 18 patients, there were 11 patients with solid pseudopapillary tumors and 7 patients with pancreatoblastoma (PBL). The tumors were located in the head of the pancreas in 13 patients (including 3 patients who underwent pancreaticoduodenectomy, 1 patient who underwent resection of the head of the pancreas with preservation of the duodenum, and 9 patients who underwent resection of the tumors). The tumors were located in the body and tail of the pancrease in 5 patients (including 3 patients who underwent resection of the body and tail of the pancreas with preservation of spleen, and 2 patients who underwent resection of tumors). Because of huge tumors, 1 patient had bilateral lung, left supraclavicular fossa lymph node and retroperitoneal lymph node metastasis, 3 patients were confirmed to have PBL by biopsy, and these tumors were resected completely after neoadjuvant chemotherapy. Postoperative pathology showed that all the 3 patients had PBL and were given systematic chemotherapy. Postoperative pancreatic fistula occurred in 1 patient and chylous fistula in another patient, both were discharged home successfully after conservative treatments. All patients were followed-up for 2-7 years, and all children were tumor-free.Conclusion:It is not difficult to diagnose pediatric pancreatic tumors by ultrasound, CT and MRI before operation, and postoperative pathology was needed to confirm the diagnosis. Function-preserving surgical resection was the treatment of choice for pancreatic tumors in children.
ABSTRACT
Objective To observe the clinical effect and complications of intravenous immunoglobulin(IVIG)in the treatment of severe adenovirus pneumonia(SAP)in children. Methods Clinical data of 210 hospitalized children with SAP from June 2009 to June 2011 were retrospectively analyzed. Patients were divided into IVIG group (109 cases) and control group (101 cases) to compare the therapeutic effects, duration of fever, length of stay in hospital, duration of mechanical ventila-tion, and complications between the two groups. Results There was no difference in the severity of illness on admission and un-derlying diseases between the two groups. Both groups were given antiviral, antibacterial and comprehensive supporting thera-py, and in the IVIG group IVIG 250-400mg/(kg.d) were administered for 3-5 d. The mean hospital stay and fever time of the IVIG group were significantly shortened comparing to that of the control group, and the time of mechanical ventilation on the IVIG group is less than that of the non-IVIG group. Incidence rate of pleural effusion, atelectas is, myocarditis and toxic enceph-alopathy in the IVIG group is lower than the control group, and the cure rateand effective therapy of the IVIG group is higher than control group, all of the difference was statistically significant (P<0.05). No adverse drug reaction was observed. Conclu-sions IVIG is safe and effective in the treatment of SAP in children.
