新生儿外寄生胎合并巨型脐膨出一例并文献复习  

Neonatal ectoparasitism with giant congenital omphalocele： a case report and a literature review

作　　者：宋华 祁泳波 单若冰 Song Hua;Yongbo;Shan Ruobing(Department of Neonatal Surger;Department of Newborn Medical Center,Municipal Women ＆ Children＇Hospital,Qingdao 266034,China)

机构地区：[1]青岛市妇女儿童医院新生儿外科,266034 [2]青岛市妇女儿童医院新生儿医学中心,266034

出　　处：《中华小儿外科杂志》2018年第8期612-615,共4页Chinese Journal of Pediatric Surgery

基　　金：青岛市科技局资助项目（14-2-3-28-nsh）

摘　　要：目的探讨新生儿外寄生胎合并巨型脐膨出的诊疗方法。方法回顾性总结分析1例外寄生胎合并巨型脐膨出新生儿临床资料，并通过中国知网（CNKI）、万方数据库、维普网、中国生物医学期刊文献数据库、Pubmed、MEDLINE等数据库检索近30年国内外相关文献进行复习并总结经验。结果本例患儿出生前经产前彩超已确诊，并经多学科会诊，预先制定了产后的手术计划。患儿生后1 h即在全身麻醉下行脐膨出修补术＋外寄生胎切除术。脐部膨出肿物为部分肝脏，给予还纳，完整切除腹部隆起并修复腹壁。术后病理证实了脐膨出病理改变，手术切除的腹壁赘生物符合寄生胎病理改变。术后继续多学科协同治疗，患儿于术后第14天治愈出院。出院后随访6个月，生长发育良好，无明显术后并发症。通过数据库检索，共检索到国内外报道的外寄生胎合并脐膨出者7例，其中6例经手术治疗预后良好，1例引产。结论外寄生胎合并巨型脐膨出极为罕见，目前唯一的治疗手段是手术切除。对于外寄生胎合并巨型脐膨出进行手术时需兼顾两种疾患的病理解剖特点。术前可通过超声等手段对患儿寄生胎和脐膨出的局部解剖情况进行充分的评估，制定完善的手术计划；术后多学科联合制定后续治疗计划。出院后需对患儿进行长期随访，明确有无恶变征象。ObjectiveTo review the diagnosis and treatment of neonates of ectoparasitism with giant congenital omphalocele.MethodsClinical profile was retrospectively analyzed for 1 case with ectoparasitism with giant congenital omphalocele. The databases of CNKI, Wanfang, VIP, China Biology Medicine and PubMed were used for retrieving the relevant information over the last 30 years. ResultsThe diagnosis of ectoparasitism with giant congenital omphalocele was confirmed by prenatal color Doppler ultrasound and then a comprehensive surgery plan implemented by multi-disciplinary team （MDT）. Repair of abdominal wall and resection of ectoparasitism were operated at 1h postnatally under general anesthesia. During operation, abdominal wall was repaired and bulging of liver returned into abdominal cavity. All neoplasms were verified to be of fetal pathology. The patient was cured postoperatively at Day 14 by MDT. Postoperative recovery was excellent during a follow-up period of 6 months. A total of 7 cases of ectoparasitism with congenital omphalocele were retrieved from the database. Six were successfully operated while another case was aborted. ConclusionsEctoparasitism is exceedingly rarely accompanied with giant congenital omphalocele. Currently resection is the only effective therapy. Surgeons should be aware of the pathological features of two diseases during surgery. Preoperative ultrasonic evaluations may aid optimal surgical planning. Also long-term follow-ups are necessary for monitoring malignant transformations.

关 键 词：外寄生胎 巨型脐膨出 新生儿 

分 类 号：R726.5[医药卫生—儿科]