COVID-19疑似病例合并肝母细胞瘤多学科临床讨论

米芋枚; 叶盛; 陈英虎; 陶孝芬; 王金湖

doi:10.3969/j.issn.1000-8179.2020.08.268

COVID-19疑似病例合并肝母细胞瘤多学科临床讨论

doi: 10.3969/j.issn.1000-8179.2020.08.268

米芋枚^①,,
叶盛^②,
陈英虎^①,
陶孝芬^③,
王金湖^④, ,

①.
浙江大学医学院附属儿童医院, 国家儿童健康与疾病临床医学研究中心感染科(杭州市 310051)
②.
浙江大学医学院附属儿童医院, 国家儿童健康与疾病临床医学研究中心重症医学科(杭州市 310051)
③.
浙江大学医学院附属儿童医院, 国家儿童健康与疾病临床医学研究中心呼吸科(杭州市 310051)
④.
浙江大学医学院附属儿童医院, 国家儿童健康与疾病临床医学研究中心肿瘤外科(杭州市 310051)

详细信息

作者简介:
米芋枚, 专业方向为小儿感染性疾病的临床诊治和基础研究。E-mail:6510033@zju.edu.cn

通讯作者:
王金湖, wjh@zju.edu.cn

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- 被引次数: 0
出版历程
- 收稿日期: 2020-03-24
- 刊出日期: 2020-12-26

Multidisciplinary diagnosis and treatment of a child with hepatoblastoma and suspected coronavirus disease

Yumei Mi^{①
,},
Sheng Ye^②,
Yinghu Chen^①,
Xiaofen Tao^③,
Jinhu Wang^{④
, ,}

①.
Division of Infectious Disease, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310051, China
②.
Pediatric Intensive Care Unit, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310051, China
③.
Department of Respiratory Medicine, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310051, China
④.
Department of Oncological Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310051, China

More Information

Corresponding author: Jinhu Wang; E-mail:wjh@zju.edu.cn

摘要

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。
- 新型冠状病毒肺炎 /
- 肝母细胞瘤 /
- 多学科协作体系 /
- 管理 /
- 诊疗
Abstract: 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. Conclusion 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.
- corona virus disease 2019(COVID-19) /
- hepatoblastoma (HB) /
- multidisciplinary team (MDT) /
- management /
- diagnosis and treatment

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图 1 腹部增强 CT（右肝叶巨大占位）

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图 2 肺部高分辨 CT（右肺上叶少许磨玻璃影，箭头示病变部位）

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