胎儿腹部囊肿的围产结局分析  

Analysis of perinatal outcomes among fetuses with abdominal cyst

作　　者：俞钢[1] 王丽敏[2] 洪淳[1] 尚宁[2] 唐晶[1] 马小燕[2] 袁晓兰[3] 雷琼[3] 韩鹏慧[4] 张佳立[5] 

机构地区：[1]广东省妇幼保健院胎儿医学科,广州511442 [2]广东省妇幼保健院胎儿超声科,广州511442 [3]广东省妇幼保健院产科,广州511442 [4]广东省妇幼保健院放射科,广州511442 [5]广东省妇幼保健院病理科,广州511442

出　　处：《中华围产医学杂志》2015年第8期610-615,共6页Chinese Journal of Perinatal Medicine

摘　　要：目的 探讨胎儿腹部囊肿的超声影像学特征和围产结局.方法 2011年10月1日至201 3年10月31日,广东省妇幼保健院行产前胎儿系统超声检查发现胎儿腹部囊肿210例.产前对胎儿进行全面系统的超声检查,发现胎儿腹部囊肿时,观察其发生部位、形态、大小、内部回声、血流情况以及与周边邻近脏器的关系,并结合临床和遗传学情况进行评估,继续妊娠者每3-4周定期复查,直至分娩.如果囊肿巨大（直径＞4cm）,或性质不明,或病情有进展,必要时进行囊肿穿刺.分娩后新生儿进行超声检查,必要时CT检查.有手术指征者建议手术治疗;非手术者每2-6个月进行随访.分析胎儿腹部囊肿的解剖部位、性质、超声特征、临床情况及预后. 结果 210例胎儿腹部囊肿中,肝胆来源20例（l0％,20/210）,其中肝囊肿10例,胆总管囊肿7例,胆道闭锁2例,肝脏错构瘤l例.消化道来源51例（24％,51/210）,其中胎粪性腹膜炎9例,十二指肠梗阻15例,小肠梗阻10例,肛门闭锁7例,结肠梗阻3例,巨大肠系膜囊肿2例,肠重复畸形5例.肾脏和肾上腺区域来源42例（20％,42/210）,其中肾囊肿19例,膈肌下隔离肺5例,神经母细胞瘤3例,肾上腺畸胎瘤1例,肾母细胞瘤l例,多囊性肾发育不良13例.泌尿系统梗阻55例（26％,55/210）,其中肾积水34例,输尿管扩张16例,巨膀胱症5例.生殖系统来源42例（20％,42/210）,均为女性胎儿的卵巢囊肿.210例胎儿腹部囊肿中,以卵巢囊肿最多,其次为肾积水、肾囊肿、输尿管扩张及十二指肠梗阻.22例（10％,22/210）产前行囊肿穿刺抽液,未出现流产等合并症.共8例行引产及尸检,结果与超声诊断相符,其中2例十二指肠梗阻及1例肛门闭锁均合并21-三体,1例巨膀胱症合并18-三体,另外1例胆道闭锁、1例神经母细胞瘤、2例巨膀胱症因孕妇主动要求而引产.202例（96％,202/210）继续妊娠至出生;除l例十二指肠闭锁生后死亡外,�Objective To investigate the ultrasonographic features and the perinatal outcome of fetal abdominal cyst.Methods From October 1,2011 to October 31,2013,210 cases of fetal abdominal cyst were detected by fetal ultrasound examination in Guangdong Women and Children Hospital.Systemic fetal ultrasonic examination was performed and the location,shape,size,internal echo,blood flow and adjacent organs and theire relationship with the abdominal cyst were observed.Then all cases were evaluated in consideration of clinical and genetic condition.Those who decided to continue the pregnancy should be monitored once every three to four weeks until delivery.If the cyst was huge （diameter 〉 4 cm）,of unknown nature,or became worse,cyst puncture would be offered.After born,the newborns were examined by ultrasound,and CT scan when needed.Surgery were recommended if there was any indication,and those who did not need surgery were followed up for every two to six months.The location,nature,ultrasonic features,clinical status and prognosis of fetal abdominal cyst were analyzed.Results Among the 210 cases of fetal abdominal cyst,20 （10%） were originated from liver and gallbladder,including ten with hepatic cyst,seven with choledochal cyst,two with biliary atresia,one with liver hamartoma.51（24%） cases were of gastrointestinal origin,including nine cases of meconium peritonitis,15 with duodenal obstruction,ten with small bowel obstruction,seven with imperforate anus,three with colon obstruction,two with huge mesenteric cyst and five with duplication of the intestine.42 （20%） cases were originated from kidney or adrenal area,including 19 with fetal renal cyst,five with isolated lungs under the diaphragm,three with neuroblastoma,one with adrenal teratoma,one with Wilms tumor and 13 with multicystic dysplasia kidney.There were 55 （26%） cases with urinary tract obstruction,including 34 with hydronephrosis,16 with ureterectasia and five with megabladder syndrome.There were 42 （20%） cases originated from reproductive

关 键 词：胎儿疾病 腹部 囊肿 超声检查 产前 妊娠结局 

分 类 号：R714.5[医药卫生—妇产科学]