胎儿肺囊腺瘤产前特征及结局研究  

Study on Prenatal Characteristics and Outcome of Fetal Lung Cystadenoma

作　　者：冼诗瑶 梁雪梅[1] 吴欣新 冯穗华[1] 黄泳华[1] XIAN Shiyao;LIANG Xuemei;WU Xinxin;FENG Suihua;HUANG Yonghua(Department of Obstetrics,Jiangmen Central Hospital,Jiangmen,Guangdong Province,529070 China)

机构地区：[1]江门市中心医院产科,广东江门529070

出　　处：《系统医学》2021年第10期104-106,共3页Systems Medicine

摘　　要：目的探讨先天性肺囊腺瘤样畸形(CCAM)胎儿的产前特征及妊娠结局,以进一步为临床提供产前咨询及处理的病例依据。方法收集2015年1月—2020年5月期间于该院行产前诊断及孕期超声跟踪检查的100例胎儿CCAM病例。统计并分析其产前一般情况信息、分型、CVR大小及变化情况、妊娠结局等相关指标。结果100例入选病例,10例(10%)为Ⅰ型CCAM,50例(50%)Ⅱ型,40例(40%)Ⅲ型。首次发现孕周为11~31周,平均(24±7.31)周。大部分是Ⅲ级排畸超声时被发现(90/100)。所有胎儿染色体核型及染色体微阵列检查均未发现明确致病性变异。首次发现时CVR为0.07~2.16 cm^(2),平均(0.73±0.30)cm^(2)。分娩前CVR 0.06~1.56 cm^(2),平均(0.43±0.17)cm^(2)。孕期监测过程中CVR增大的有15例(15%),稳定不变者15例(15%),余65例CVR变小(65%)。5例胎儿CVR达2.16,出现心衰水肿征象,孕中期引产,其余病例预后良好。结论绝大多数胎儿期CCAM预后较好。孕期需注意跟踪肿块CVR变化情况。当CVR>1.6但若胎儿未出现心衰水肿等症状,仍可在密切监测下保留胎儿。此外,CCAM需注意与其他胎儿肺部病变相鉴别,应注意产后其他影像学检查进一步确认诊断。Objective To investigate the prenatal characteristics and pregnancy outcomes of fetuses with congenital cystadenomatous malformations(CCAM), so as to provide clinical evidence for prenatal consultation and treatment.Methods Collected 100 fetal CCAM cases who underwent prenatal diagnosis and ultrasound follow-up examination during pregnancy in the hospital from January 2015 to May 2020. Statistics and analysis of its general information,classification, CVR size and changes, pregnancy outcome and other related indicators. Results Of the 100 selected cases, 10 cases(10%) were type Ⅰ CCAM, 50 cases(50%) were type Ⅱ, and 40 cases(40%) were type Ⅲ. The first gestational week was found to be 11-31 weeks, with an average of(24±7.31)weeks. Most of them were found on grade Ⅲ ultrasound(90/100). All fetal chromosomal karyotypes and chromosome microarray examinations found no clear pathogenic variants. When first discovered, the CVR was 0.07-2.16 cm2, with an average of(0.73±0.30)cm2. The CVR before delivery was 0.06-1.56 cm2, with an average of(0.43±0.17)cm2. During pregnancy monitoring, CVR increased in15 cases(15%), stable in 15 cases(15%), and CVR decreased in the remaining 65 cases(65%). 5 fetuses had a CVR of 2.16, showed signs of heart failure and edema, and induced labor in the second trimester. The prognosis of the remaining cases was good. Conclusion The prognosis of most fetal CCAM is good. Attention should be paid to tracking the changes in the CVR of the mass during pregnancy. When CVR>1.6 but if the fetus does not have symptoms such as heart failure and edema, the fetus can still be kept under close monitoring. In addition, CCAM should be distinguished from other fetal lung lesions, and other postpartum imaging examinations should be taken to further confirm the diagnosis.

关 键 词：胎儿 肺囊腺瘤样畸形 产前超声 

分 类 号：R4[医药卫生—临床医学]