胸腔-羊膜腔引流术治疗胎儿胸部疾病的妊娠结局分析  

Pregnancy outcome analysis of fetuses with chest disease treated by thoracoamniotic Shuntings

作　　者：赵馨[1] 何薇[1] 尚宁[2] 陈丹[2] 卢建[1] 郭莉[1] 丁红珂[1] 刘倩[1] 洪淳[3] 吴菁[1] ZHAO Xin;HE Wei;SHANG Ning

机构地区：[1]广东省妇幼保健院医学遗传中心,广东广州510010 [2]广东省妇幼保健院超声诊断科,广东广州510010 [3]广东省妇幼保健院小儿胸外科,广东广州510010

出　　处：《中国产前诊断杂志（电子版）》2019年第3期43-48,共6页Chinese Journal of Prenatal Diagnosis(Electronic Version)

摘　　要：目的探讨胎儿胸腔羊膜腔分流术对胎儿胸部疾病的治疗价值。方法本研究选择10例经超声诊断为胎儿胸部疾病接受胸腔羊膜腔分流术的病例,分为胎儿胸腔积液组(FHT,4例)、肺隔离症组(BPS,2例)、不明原因胎儿水肿伴重度胸腔积液组(水肿组,4例),对其临床资料进行回顾性分析,探讨胸腔-羊膜腔分流术对胎儿胸部疾病治疗的临床价值。结果①4例FHT生存率达100%,50%发生引流管移位及早产,且存在新生儿期并发症;②水肿组胎儿生存率达50%,均为早产出生,1例因染色体异常选择终止妊娠,1例产后确诊Noonan综合征新生儿死亡;③1例BPS术后流产,1例带管至足月出生,新生儿手术后肺发育不良,感染,新生儿死亡。结论胸腔-羊膜腔分流术可用于治疗原发性重度胸腔积液及伴重度胸腔积液不明原因胎儿水肿有良好的治疗效果,可有效改善妊娠结局,但应用于肺隔离症,其预后与肺发育程度相关。Objective To evaluate the therapeutic effect of thoracoamniotic shunting on fetuses with chest disease.Method We retrospectively analyzed the treatment procedures of 10 fetuses diagnosed with chest disease and treated by thoracoamniotic Shunting.The 10 cases were divided into three groups,pleural effusion(FHT)group(n=4),bronchopulmonary sequestrations(BPS)group(n=2),and fetal hydrops with severe pleural effusion group(n=4).Results①All 4 cases in FHT group survived,in which 2(50%)underwent drainage tube displacement and premature delivery with neonatal complications.②2(50%)cases in hydrops group survived,1 of the other 2 cases chose termination of pregnancy due to chromosomal abnormalities and the another one was identified as Noonan syndrome postnatally who underwent neonatal death.③2 cases in BPS group failed to survive,in which 1 case underwent miscarriage after thoracoamniotic shunting and the other case suffered from neonatal death due to lungdysplasia.Conclusions The effect of thoracoamniotic shunting on fetuses with severe pleural effusion and hydrops can be well accepted.However,thoracoamniotic shuntings in BPS fetuses is also likely to be discussed.

关 键 词：胸腔-羊膜腔分流术 胎儿宫内治疗 胎儿胸腔积液 胎儿水肿 先天性囊性腺瘤样畸形 肺隔离症 

分 类 号：R714.56[医药卫生—妇产科学]