胎儿肠管扩张的诊断与预后分析  

Diagnosis and clinical prognosis of fetal bowel dilatation

作　　者：郭艳杰[1] 郭邑[2] 关怀[3] 尚丽新[4] 

机构地区：[1]大连医科大学微生态教研室,大连116044 [2]大连市妇产医院产科,大连116033 [3]解放军第210医院妇产科,大连116021 [4]北京军区总医院妇产科,北京100700

出　　处：《发育医学电子杂志》2016年第1期30-33,共4页Journal of Developmental Medicine (Electronic Version)

摘　　要：目的了解胎儿肠管扩张与临床预后的相关性,为产前诊断、处理、咨询提供依据。方法回顾性分析2010年1月1日至2015年9月30日于大连市妇产医院经产前超声检查诊断为胎儿肠管扩张的孕妇资料,并跟踪随访临床预后。结果共纳入127例孕妇,49例预后良好,78例预后不良。78例预后不良者中小肠畸形为50例次(64.1%),结肠闭锁9例次(11.5%),十二指肠闭锁及狭窄9例次(11.5%),直肠肛门闭锁8例次(10.3%),先天性巨结肠4例次(5.1%)。其他系统畸形包括先天性心脏病6例次、腹壁裂2例次、尿道下裂2例次、唇腭裂2例次、多囊肾1例次、肾盂扩张1例次、单脐动脉1例次。另有3例患者存在染色体核型异常。结论胎儿肠管扩张与消化道畸形密切相关,应予以正确的管理与指导。Objective To explore the correlation between fetal bowel dilatation and clinical prognosis for providing the basis for prenatal diagrbsis,treatment,and consultation. Method 127 cases of fetal bowel dilatation diagnosed prenatally in Dalian Obstetrics and liynecology Hospital from Jan 1,2010 to Sep 30,2015 were analyzed retrospectively and followed up. Results Among the 127 cases, the prognosis of 49 patients was good, and 78 neonates were diagnosed with abnormalities. Small intestinal malformation ratio was 64.1%（50/78）. Colonic atresia and stenosis ratio was 11.5%（9/78）. Duodenal atresia and stenosis ratio was 11.5%（9/78）. Rectal anal atresia ratio was 10.3%（8/78）, and congenital megacolon ratio was 5.1%（4/78）. In addition, the digestive system malformation could exist alone or coexisted with other malformation, including 6 cases of congenital heart disease, 2 cases of gastroschisis, 2 cases of hypospadias, 2 cases of cleft lip and palate, 1 case of polycystic kidney, and 1 case of pyelectasia, 1 case of single umbilical artery. Chromosome abnormality was found in 3 patients. Conclusions Fetal bowel dilatation is closely related to the digestive tract malformation. It should be given the right management and guidance.

关 键 词：肠管扩张 预后 肠梗阻 胎儿 

分 类 号：R714.5[医药卫生—妇产科学]