多学科联合诊治胎儿肠扭转两例  

Multidisciplinary team working for diagnosis and treatment of fetal intestinal volvulus: report of two cases

作　　者：崔红梅[1] 吕玲[1] 李天刚[2] 岳志成 石静云[3] 顾琦[4] 唐汉博 Cui Hongmei;Ling Lyv;Li Tiangang;Yue Zhicheng;Shi Jingyun;Gu Qi;Tang Hanbo(Department of Obstetrics,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China;Department of Ultrasonography,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China;Department of Neonatology,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China;Department of Pediatric Surgery,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China;Department of Cardiovascular Surgery,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院产科,兰州730050 [2]甘肃省妇幼保健院超声科,兰州730050 [3]甘肃省妇幼保健院新生儿科,兰州730050 [4]甘肃省妇幼保健院儿外科,兰州730050 [5]甘肃省妇幼保健院心血管外科,兰州730050

出　　处：《中华围产医学杂志》2021年第9期689-692,共4页Chinese Journal of Perinatal Medicine

基　　金：国家重点研发计划(2018YFC1002504)。

摘　　要：本文报道了2例胎儿肠扭转的诊治过程。病例1因“孕33周+4,自觉胎动减少”就诊于甘肃省妇幼保健院(简称本院),病例2因“孕32周+5外院超声发现肠管扩张”转诊至本院。本院超声检查发现2例胎儿肠管扩张伴典型“漩涡”征或“咖啡豆”征。经过多学科会诊讨论,行急诊剖宫产,2例新生儿均行产时外科手术,术中确诊肠扭转、肠坏死,手术切除坏死肠管。病例1患儿术后恢复良好;病例2患儿在肠道手术后并发肺动脉血栓,24 h内再次行肺动脉切开取栓术,术后患儿恢复良好。随访2例患儿各生长参数及神经系统发育测评均未见明显异常。We report the diagnosis and treatment of two cases of fetal intestinal volvulus.Case 1 presented to Gansu Provincial Maternity and Child-care Hospital due to reduced fetal movements at 33+4 weeks of gestation.Case 2 was referred to our hospital from a local hospital because of fetal bowel dilatation by ultrasound at 32+5 weeks.Both cases were found to have fetal bowel dilatation with typical"whirlpool"or"coffee bean"signs on ultrasound after admission.After multidisciplinary consultation and discussion,an emergency cesarean section was performed,during which the two neonates underwent surgical operation and resection of necrotic bowel loops after confirming the diagnosis of volvulus and intestinal necrosis.Case 2 suffered from pulmonary artery thrombosis after the bowel surgery,and underwent pulmonary artery incision and embolectomy within 24 hours.Both newborns recovered well after the operation,whose growth parameters and nervous system development was normal for follow-up.

关 键 词：肠扭转 胎儿疾病 超声检查 

分 类 号：R714.5[医药卫生—妇产科学]