摘要
目的:探讨疫情期间新型冠状病毒感染(corona virus disease 2019,COVID-19)疑似病例合并肝母细胞瘤(hepatoblastoma,HB)患儿的诊治流程和管理体会。方法:2020年2月浙江大学医学院附属儿童医院收治1例疑似严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)感染合并HB患儿,通过多学科协作体系(multidisciplinary team,MDT)的诊治过程。经MDT讨论后,对患儿进行SARS-CoV-2核酸及抗体、血常规、肿瘤标记物、胸腹部CT以及超声等必要的辅助检查;化疗采用顺铂+5-氟尿嘧啶+长春新碱(C5V)方案,同时予头孢噻肟抗感染以及对症支持治疗。结果:患儿确诊为HB低危组,排除COVID-19,并顺利完成HB的第一阶段化疗疗程。住院1周后患儿体温恢复正常,精神食欲好转,各项指标达到出院标准,继续完成14天隔离治疗后出院。结论:疫情期间,对于疑似SARS-CoV-2感染的新发HB患儿,医务人员在尽可能快速地诊断和治疗肿瘤的同时,一定要兼顾对病毒的防控。MDT协作诊疗模式,有利于保障整个诊疗过程安全顺利地实施。
Objective:To discuss the diagnosis,treatment,and multidisciplinary management of a child with hepatoblastoma(HB)and suspected coronavirus disease(COVID-19).Methods:A child with HB and suspected COVID-19 was admitted to the Children's Hospital,Zhejiang University School of Medicine,in February 2020.The diagnosis and treatment plan were discussed by a multidisciplinary team(MDT).After the MDT discussion,necessary examinations and tests were performed,including routine blood tests,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)ribonucleic acid(RNA)and antibody tests,tumor marker tests,chest and abdomen computed tomography(CT),and an ultrasound.The administered treatment included the cisplatin+5-fluorouracil+vincristine(C5V)regimen and cefotaxime.Results:The patient was diagnosed as low-risk HB and completed the first stage of HB chemotherapy after the diagnosis of COVID-19 was ruled out.After 1 week in the hospital,the patient's body temperature returned to normal,the disposition and appetite improved,and all indexes reached the discharge standard.After 14 days of isolation,the patient was discharged.Conclusions:For children with newly diagnosed HB suspected of having COVID-19 during the pandemic period,clinicians must consider the prevention and control of COVID-19 while diagnosing and treating HB as soon as possible.Multidisciplinary management is beneficial for ensuring the development of a safe and efficient treatment plan.
作者
米芋枚
叶盛
陈英虎
陶孝芬
王金湖
Yumei Mi;Sheng Ye;Yinghu Chen;Xiaofen Tao;Jinhu Wang(Division of Infectious Disease,The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310051,China;Pediatric Intensive Care Unit,The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310051,China;Department of Respiratory Medicine,The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310051,China;Department of Oncological Surgery,The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310051,China)
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2020年第8期407-410,共4页
Chinese Journal of Clinical Oncology
关键词
新型冠状病毒肺炎
肝母细胞瘤
多学科协作体系
管理
诊疗
corona virus disease 2019(COVID-19)
hepatoblastoma(HB)
multidisciplinary team(MDT)
management
diagnosis and treatment
