Management and Immediate Outcome of Common Pediatric Oncological Emergencies from a Single Centre

Radhika Raman, Sreenidhi Ramakrishna, Lakshmi Muthukrishnan
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Abstract

The first presentaion of children with a malignancy is often an emergency. Pediatric oncological emergencies need to be recognized and managed early and effectively for a better outcome. In this prospective study of children, with oncological emergencies, we aimed to study the nature of oncological emergencies, emergency management and immediate outcome. There were 83 patients with 110 visits with median age of 6 years. Leukemia constituted 50.6% and 92.8% was acute lymphocytic, 26.5% intracranial malignancies 59% of them posterior fossa tumors. 36.4%, presented with fever, 18% severe anemia and 16.45 % febrile neutropenia, 8% TLS (tumor lysis syndrome) and 4.5% had respiratory distress as the presentation. Presenting symptoms in 31% were neurological. 42.7% required parenteral antibiotics and 16.4% packed cell tranfusion. 90.4% of blood cultures were negative. 26.5% needed intensive care, 12 required neurosurgical procedure.
单个中心常见儿科肿瘤急症的处理和近期疗效
儿童首次出现恶性肿瘤往往是急诊。为了获得更好的治疗效果,必须及早识别和有效处理小儿肿瘤急症。在这项针对儿童肿瘤急诊的前瞻性研究中,我们旨在研究肿瘤急诊的性质、急诊处理和即时结果。共有 83 名患者,110 次就诊,中位年龄为 6 岁。白血病占 50.6%,急性淋巴细胞性白血病占 92.8%,颅内恶性肿瘤占 26.5%,其中后窝肿瘤占 59%。36.4%的患者表现为发热,18%的患者表现为严重贫血,16.45%的患者表现为发热性中性粒细胞减少,8%的患者表现为肿瘤溶解综合征(TLS),4.5%的患者表现为呼吸困难。31%的患者出现神经系统症状。42.7%的患者需要肠外抗生素,16.4%的患者需要填料细胞输注。90.4%的血液培养呈阴性。26.5%的患者需要重症监护,12名患者需要进行神经外科手术。
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