膀胱外翻产前超声特征及漏误诊原因分析  

Prenatal Ultrasound Features of Bladder Exstrophy and Causes of Missed Diagnosis and Misdiagnosis

作　　者：侯晴沙 颜芳[1] 董旭东[1] 刘焕玲[1] 李秀玲[1] 陈醇 HOU Qing-sha;YAN Fang;DONG Xu-dong;LIU Huan-ling;LI Xiu-ling;CHEN Chun(Department of Obstetrics,the First People's Hospital of Yunnan Province the Affiliated Hospital of Kunming University of Science and Technology,Kunming 650032,China)

机构地区：[1]云南省第一人民医院,昆明理工大学附属医院产科,昆明650032

出　　处：《临床误诊误治》2022年第1期6-8,12,共4页Clinical Misdiagnosis & Mistherapy

基　　金：云南省教育厅科学研究基金项目(2019Y0366);云南省科技厅科技计划项目(202001AY070001-287)。

摘　　要：目的总结胎儿膀胱外翻的超声图像特征,分析漏诊和误诊原因。方法回顾性研究2018年1月—2021年1月3例漏诊和误诊的膀胱外翻病例资料。结果本文3例膀胱外翻,其中2例外院误诊为尿道下裂,本中心产前超声会诊后诊断为膀胱外翻合并尿道上裂可能,该诊断引产后得到证实。1例外院超声检查未探及胎儿膀胱,本中心产前超声会诊后诊断为胎儿膀胱外翻可能,足月顺产后经临床证实为膀胱外翻,后续行外科修复手术治疗。结论胎儿膀胱外翻产前易发生漏诊和误诊,产前超声检查时不能忽略对膀胱的观察,同时还需注意胎儿脐带腹壁入口位置、前下腹壁皮肤情况、外生殖器等,避免漏诊和误诊。Objective To summarize the ultrasonographic features of fetal bladder exstrophy and to analyze causes of missed diagnosis and misdiagnosis.Methods Clinical data of 3 patients with bladder exstrophy who had been missed or misdiagnosed between January 2018 and January 2021 was retrospectively analyzed.Results Among the 3 patients with bladder exstrophy,2 were misdiagnosed as hypospadias previously in other hospitals,and then they were diagnosed as having bladder exstrophy combined with epispadias after the prenatal ultrasound consultation in our center,and the diagnosis was confirmed after induction of labor;fetal bladder of another patient was not detected by ultrasound in other hospital and fetal bladder exstrophy was suspected after prenatal ultrasound consultation in our center,and the diagnosis was clinically confirmed after full-term vaginal delivery,and subsequent surgical repair was performed.Conclusion Fetal bladder exstrophy is more likely to be missed or misdiagnosed in prenatal ultrasound examinations,so the observation of bladder should not be ignored during prenatal ultrasound scan.It is necessary to observe skin in the umbilical cord entrance and anteroinferior abdominal wall,external genitalia and so on in order to avoid missed diagnosis and misdiagnosis.

关 键 词：膀胱外翻 胎儿 超声检查 产前 误诊 尿道下裂 漏诊 

分 类 号：R694.12[医药卫生—泌尿科学]