新生儿腹膜后淋巴管瘤并文献复习  

Retroperitoneal lymphangiomas in neonates: a case report and literature review

作　　者：傅益永 肖甜甜 巨容 高淑强 习玉峰 张利兵 金梅 杨胜 Fu Yiyong;Xiao Tiantian;Ju Rong;Gao Shuqiang;Xi Yufeng;Zhang Libing;Jin Mei;Yang Sheng(Department of Neonatology,Chengdu Women′s and Children′s Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 611731,Sichuan Province,China;Department of Pediatric Surgery,Chengdu Women′s and Children′s Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 611731,Sichuan Province,China;Department of Ultrasonography,Chengdu Women′s and Children′s Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 611731,Sichuan Province,China)

机构地区：[1]电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院新生儿科,611731 [2]电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院小儿外科,611731 [3]电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院超声科,611731

出　　处：《中华妇幼临床医学杂志（电子版）》2019年第5期527-534,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：四川省卫生计生委科研课题(18PJ046)~~

摘　　要：目的 探讨新生儿腹膜后淋巴管瘤的临床特点与诊治策略。方法 选择2017年7月3日,因“生后腹胀31 min”收入成都市妇女儿童中心医院新生儿科,并确诊的1例腹膜后淋巴管瘤新生儿为研究对象。回顾性分析该例新生儿的临床病例资料,总结其临床特点和诊治经过,并进行相关文献复习。本研究对新生儿腹膜后淋巴管瘤相关文献的检索策略为:以“淋巴管瘤”“腹膜后淋巴管瘤”“淋巴管畸形”“新生儿”“lymphangioma”“retroperitoneal lymphangioma”“lymphatic malformation”及“neonate”为关键词,检索中国知网数据库、PubMed等国内外文献数据库建库至2018年12月,收录的关于新生儿腹膜后淋巴管瘤的文献,并总结该病临床特点和诊治方案。本研究符合2013年修订的《世界医学协会赫尔辛基宣言》要求。结果 本例患儿为女性,入院诊断为腹腔积液待查;入院年龄为生后31 min,其病史采集与诊治过程如下。①病史采集:生后腹胀。母亲于孕龄分别为24、40孕周时,接受产前胎儿超声检查均提示胎儿腹腔见囊性占位、腹腔大量积液。患儿出生后除腹胀、腹围进行性增加外,无其他明显异常表现。生后2 d内对该例患儿行腹腔穿刺2次,均抽出较多淡黄色液体,腹水检查结果显示为渗出液。腹部X射线摄片、超声及CT检查,均显示腹腔囊性占位、腹腔大量积液。②手术、治疗经过及转归:患儿在全身麻醉下,共计进行3次手术,具体如下。第1次,于生后第3天对其进行腹腔镜探查术及淋巴液漏口结扎术,术中清理腹腔淡黄色清亮液体约600 mL,手术后有明显的淋巴液漏,腹腔引流液量大,平均为127.2 mL/d,并且患儿出现营养不良表现。第2次,于生后第28天对其进行腹膜后肿物切除术,术中切除淋巴管样异常增生病灶送组织病理学检查结果显示,“左侧腹膜后肿物符合淋巴管瘤”,术后腹腔引流液量明显减少Objective To explore the clinical characteristics, diagnosis and treatment strategies of neonatal retroperitoneal lymphangioma. Methods On July 3 of 2017, due to "abdominal distension for 31 minutes after birth", the female neonate was admitted to Department of Neonatology of Chengdu Women′s and Children′s Central Hospital and was definitively diagnosed as retroperitoneal lymphangiomas, was selected as research subject. The clinical data of the neonate was analyzed retrospectively, and the clinical characteristics, diagnosis and treatment process were summarized, and related studies were reviewed. With the following key words of "lymphangioma""retroperitoneal lymphangioma""lymphatic malformation""neonate" both in Chinese and in English, studies related to neonate with retroperitoneal lymphangiomas were searched from China National Knowledge Infrastructure database, PubMed and others domestic and foreign literature databases from construction to December 2018, and clinical features, diagnosis and treatment methods of these studies were summarized. This study was consistent with the World Medical Association Declaration of Helsinki revised in 2013. Results The female infant was diagnosed as seroperitoneum to be investigated on admission when she was 31 minutes old after birth. The history taking, diagnosis and treatment processes were as follows.① Medical history taking: The infant had abdominal distension after birth. Abdominal cystic mass and massive seroperitoneum of fetus were identified by prenatal fetal ultrasound at gestational age of 24 and 40 weeks of her mother. After her birth, there were no other abnormal appearances except abdominal distension and progressive increase of abdominal circumference. Peritoneocentesis were performed twice to her in the first 2 days after her birth, and both aspirated much yellowish fluid, and ascites examination showed exudate. Abdominal X-ray, ultrasonography and CT examinations all showed cystic mass and massive ascites in abdominal cavity.② Surgery, treatment pro

关 键 词：淋巴管瘤 腹部囊性淋巴管瘤 超声检查 淋巴管畸形 乳糜性腹水 胎儿 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]