先天性小肠闭锁或狭窄的产前超声诊断分析  

Prenatal Ultrasound Diagnosis of Congenital Intestinal Atresia or Stenosis

作　　者：田蓉 彭清海[2] 袁红霞[1] 夏仁鹏[3] TIAN Rong;PENG Qing-hai;YUAN Hong-xia(Department of Ultrasound,Changsha maternal and children health care hospital,Changsha 410007)

机构地区：[1]长沙市妇幼保健院,湖南长沙410007 [2]中南大学湘雅二医院,湖南长沙410011 [3]湖南省儿童医院新生儿外科,湖南长沙410007

出　　处：《医学临床研究》2020年第7期1026-1029,共4页Journal of Clinical Research

摘　　要：【目的】总结产前超声诊断小肠闭锁(SBA)或小肠狭窄(SBS)患儿的临床资料,为产前诊断胎儿先天性SBA临床诊断提供参考。【方法】回顾性分析2013年1月至2017年12月于本院超声科进行产前彩超筛查并发现胎儿肠管扩张并于生后手术或引产后尸体解剖证实为SBA或SBS的胎儿的临床资料,并进行统计学分析。【结果】208例肠管扩张胎儿中,出生后手术或引产后尸体解剖证实为SBA或SBS共58例。其中位于十二指肠18例(31.03%),空肠15例(25.9%),回肠25例(43.1%)。58例中合并其他畸形者13例,合并21-三体综合征4例(22.22%),空肠闭锁均未发现染色体异常。十二指肠闭锁或狭窄引产率(33.33%),产后手术率(66.67%),治愈率(91.67%);空肠闭锁引产率(46.67%),产后手术率(53.33%),治愈率(87.5%);回肠闭锁引产率(48%),产后手术率(52%),治愈率(76.92.%)。各组之间治愈率比较差异无统计学意义(P>0.05)。【结论】产前超声对筛查先天性SBA或SBS具有重要的作用,因其手术效果好,治愈率高,故产前明确诊断可减少不必要的引产。【Objective】To summarize the clinical data of prenatal ultrasound diagnosis of small intestinal atresia(SBA)or small intestinal stenosis(SBS),so as to provide reference for prenatal diagnosis of fetal congenital SBA.【Methods】A retrospective analysis of 208 cases of prenatal color Doppler ultrasound screening in our hospital from January 2013 to December 2017 was conducted.Fetal intestinal dilatation was found and autopsy was performed after operation or induction of labor.The clinical data of fetuses confirmed as SBA or SBS were analyzed statistically.【Results】Among 208 fetuses with dilated bowel,58 were confirmed as SBA or SBS by autopsy after operation or induction of labor.Among them,18 cases(31.03%)were located in duodenum,15 cases(25.9%)in jejunum and 25 cases(43.1%)in ileum.Among the 58 cases,13 cases were complicated with other malformations and 4 cases(22.22%)were complicated with trisomy 21 syndrome.The induced labor rate of duodenal atresia or stenosis was 33.33%,the postpartum operation rate was 66.67%,and the cure rate was 91.67%;the induced labor rate of jejunal atresia was 46.67%,the postpartum operation rate was 53.33%,and the cure rate was 87.5%;the induced labor rate of ileal atresia was 48%,the postpartum operation rate was 52%,and the cure rate was 76.92%.There was no significant difference in the cure rate among the groups(P>0.05).【Conclusion】Prenatal ultrasound plays an important role in screening congenital SBA or SBS.Because of its good surgical effect and high cure rate,prenatal diagnosis can reduce unnecessary induction of labor.

关 键 词：肠闭锁/外科学 肠闭锁/诊断 超声检查 产前 

分 类 号：R726.571.7[医药卫生—儿科]