胎儿孤立性轻度侧脑室扩张及其预后的随访研究  

Follow-up study of prognosis of fetuses with solitary mild lateral ventricular dilation

作　　者：刘明松 章红燕 孔文翠 朱玲 梁友 刘玉琴 Liu Mingsong;Zhang Hongyan;Kong Wencui;Zhu Ling;Liang You;Liu Yuqin(Department of Ultrasound,Huzhou Maternity and Child Health Care Hospital,Huzhou 313000,China)

机构地区：[1]浙江省湖州市妇幼保健院超声科,313000

出　　处：《中华医学超声杂志（电子版）》2020年第10期1016-1020,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨孤立性轻度侧脑室扩张胎儿产前及出生后的随访预后结果。方法纳入2016年6月至2018年6月在湖州市妇幼保健院足月分娩的产前诊断为孤立性轻度侧脑室扩张的新生儿73例。所有患儿在第1次超声发现侧脑室扩张后每隔2周进行一次侧脑室变化情况复查直至出生。出生后7 d内行MRI检查,后每隔3个月超声随访观察侧脑室扩张变化情况,随访至1岁。所有小儿均于出生后第3、6、12个月采用贝利婴幼儿发展量表的智力发育指数(MDI)和心理运动发育指数(PDI)进行发育评估,依据评分将发育程度分为优秀、良好和低下。观察侧脑室扩张变化情况,并分析不同变化情况新生儿的预后结果。结果73例新生儿中,胎儿期及出生后侧脑室扩张宽度逐渐缩小者28例,无明显变化者38例,进行性增大者7例。超声随访至1岁,逐渐缩小组患儿全部无扩张表现;无明显变化组中仅1例存在扩张;进行性增宽组患儿中3例进展为轻度脑积水,3例无明显变化,1例进行性缩小。出生后1年,进行性增宽组患儿PDI与MDI评分均低于逐渐缩小组和无明显变化组,差异均有统计学意义(PDI:t=14.2093、12.8738;MDI:t=15.4998、17.8503,P均<0.05)。逐渐缩小者无一例MDI和PDI评分低下;无明显变化者,1例随访MDI和PDI评分发育低下;进行性增宽的7例中,5例PDI评分低下,4例MDI评分低下。3组之间的PDI和MDI量表评分分级比较,差异均有统计学意义(H=36.161、31.938,P均<0.001)。结论孤立性轻度侧脑室扩张的胎儿,如随访观察侧脑室扩张无明显变化或逐渐缩小,一般预后良好,如出现扩张进行性增宽,预后不良的风险增加,需谨慎咨询。Objective To investigate the prenatal and postnatal outcomes of fetuses with isolated mild lateral ventricular dilatation.Methods Seventy-three newborns with isolated mild lateral ventricular dilatation diagnosed before delivery at The Huzhou Maternity and Child Health Hospital from June 2016 to June 2018 were included.All patients were examined every two weeks after the first discovery of lateral ventricular dilatation until birth.MRI examination was performed within 7 days after birth,and follow-up by ultrasound every 3 months was then performed to observe the dilation of the lateral ventricle up to 1 year old.The mental development index(MDI)and psychomotor development Index(PDI)of The Bailey Infant Development Scale were used to evaluate the development of all children after birth.According to the scores obtained,the development statue was classified as excellent,good,and poor,and the development was evaluated at 3,6,and 12 months.The changes of lateral ventricular dilatation were observed and the prognosis of newborns with different changes was analyzed.Results Among the 73 newborns,28(38.4%,28/73)had reduced dilatation of the lateral ventricle during the fetal stage and after birth,38(52.1%,38/73)had no obvious changes,and 7(9.5%,7/73)had progressive enlargement.One year after birth,the PDI and MDI scores of the patients with progressive enlargement were significantly lower than those of the other two groups(PDI:t=14.2093 and 12.8738,respectively,P<0.01;MDI:t=15.4998 and 17.8503,respectively,P<0.05).The MDI and PDI scores of 28 patients were excellent,and no cases had a poor prognosis.Among the 38 patients with no significant changes,1 had poor MDI and PDI scores,2 had good scores,and 35 had excellent scores.Among the 7 patients with progressive enlargement,5 had low PDI scores and 4 had low MDI scores.The results of neonatal prognosis differed significantly among the three groups(PDI:H=36.161,P<0.001;MDI:H=31.938,P<0.001).Conclusion For fetuses with isolated mild dilatation of the lateral ventricle,if the

关 键 词：胎儿 超声检查 产前 侧脑室 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]