胎粪性腹膜炎产前超声诊断及其预后分析  

Meconium peritonitis:prenatal ultrasonographic findings and the analysis of prognosis

作　　者：何花[1] 谢红宁[1] 李丽娟[1] 朱云晓[1] 

机构地区：[1]中山大学附属第一医院妇产超声科,广东广州510080

出　　处：《中国实用妇科与产科杂志》2008年第5期357-359,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：广东省教育部产学研合作项目(2007B090400140)

摘　　要：目的探讨胎粪性腹膜炎产前超声诊断与胎儿临床结局的相关性。方法总结2003年1月至2007年4月在中山大学附属第一医院产前超声诊断、出生后证实的胎粪性腹膜炎病例,按产前末次超声表现将病例分为4组:A组为单纯腹腔内钙化灶,B组为腹腔内钙化灶伴腹水或假性囊肿或肠管扩张,C组为腹腔内钙化灶伴2种相关异常声像,D组为腹腔内钙化灶伴3种或以上相关异常声像,比较4组胎儿出生后临床结局。结果产前超声诊断胎粪性腹膜炎共38例,其中29例出生。出生后手术率:A组为0(0/13),B组为33·3%(3/9),C组为66·7%(2/3),D组为100·0%(4/4),不同组别手术率比较差异有统计学意义(P<0·01)。出生病例病死率10·3%(3/29),其中1例单纯腹腔内钙化灶病例为早产,1例拒绝手术,1例术后败血症死亡。26例存活,除1例出生4个月时因肠梗阻行急诊手术,余随访至今无异常。结论胎粪性腹膜炎的产前超声表现与胎儿临床结局关系密切,出生后手术率随合并相关异常增多而增高;大部分单纯腹腔钙化灶胎粪性腹膜炎临床结局良好。Objective To evalttate the correlation between prenatal ultrasound features and postnatal outcome of meconium peritonitis （MP）. Methods All cases of MP diagnosed by prenatal ultrasound examination and confirmed postnataly from January 2003 to April 2007 in the First Affiliated Hospital of Sun Yat-sen University were included. The cases were divided into 4 grades according to the prenatal sonographic findings. Grade A： isolated intra-abdominal calcifications. Grade B ： intra-abdominal calcifications and ascites or pseudocyst, or bowel dilation. Grade C ： intra-abdominal calcifications and two associated findings. Grade D： intra-abdominal calcifications and more than three sonographic features. Results MP was diagnosed in 38 fetuses. Twenty-nine of them were born. Neonatal surgery was required in 0 （0/13） 6f newborns with grade A, and 33. 3% （3/9） of grade B, 66. 7% （2/3） of grade C,and 100. 0% （4/4） of grade D, respectively （P 〈 0. 01 ）. Neonatal mortality was 10. 3% （3/29） , one for premature delivery, one for denying surgery and one for septicemia after surgery. Twenty-six cases are still alive after four years of follow-up, all being thrive except one who needed urgent surgery in four months after delivery. Conclusions Prenatal sonographic features are closely related to postnatal outcome. The neonatal surgery rate increases with the number of sonographic findings of MP. The postnatal out-come is good in most of the fetuses with isolated intra-abdominal calcifications.

关 键 词：胎粪性腹膜炎 胎儿 超声检查 产前 

分 类 号：R71[医药卫生—妇产科学]