胎儿期诊断支气管肺隔离症67例随访研究  

Follow up study of 67 cases of diagnosis of bronchopulmonary sequestration during fetal period

作　　者：苟丽娟 李正红[1,2] 全美盈 王琳 于仲勋 杨萌 吕珂 Gou Lijuan;Li Zhenghong;Quan Meiying;Wang Lin;Yu Zhongxun;Yang Meng;Lyu Ke(Department of Pediatrics,Peking Union Medical College,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China;State Key Laboratory of Difficult,Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Ultrasound Medicine,Peking Union Medical College,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院儿科,北京100730 [2]中国医学科学院北京协和医学院、北京协和医院疑难重症及罕见病国家重点实验室,北京100730 [3]中国医学科学院、北京协和医学院、北京协和医院超声医学科,北京100730

出　　处：《中华新生儿科杂志(中英文)》2025年第1期24-27,共4页Chinese Journal of Neonatology

基　　金：中央高水平医院临床科研业务费(2022-PUMCH-B-077)。

摘　　要：目的了解胎儿期诊断支气管肺隔离症病例的预后。方法回顾性分析北京协和医院2013年1月至2020年12月胎儿期诊断支气管肺隔离症患儿的临床特点、胎儿结局及出生后随访情况。结果(1)胎儿期诊断支气管肺隔离症67例,孕妇平均年龄30.1岁,均为孕中期诊断。(2)病变位于左侧48例(71.6%),右侧18例(26.9%),双侧1例(1.5%)。10例心脏移位患儿中合并胸腔积液、羊水增多各2例,腹腔积液、心包积液、全身水肿各1例。(3)随访胎儿结局45例,其中引产8例,出生新生儿37例。出生后死亡1例、存活36例。失访病例22例。与随访病例相比,失访病例胎儿先天性肺气道畸形容积比更小,且均不伴有心脏移位。(4)37例出生新生儿中男23例,女14例;足月儿34例,早产儿3例。新生儿窒息2例,1例合并膈疝死亡。行隔离肺切除术14例,手术年龄5 d至30个月,中位年龄11.5个月。随访至2~10岁,有呼吸道症状3例,1例伴发育迟缓但病因不详。结论支气管肺隔离症患儿多数预后良好,产前诊断后应在胎儿期、新生儿期及生后纵向规律追访。Objective To investigate the clinical characteristics and prognosis of fetal bronchopulmonary sequestration.Methods The characteristics of fetal ultrasound findings of bronchopulmonary sequestration retrieved from January 2013 to December 2020 at Beijing Union Medical College Hospital were retrospectively analyzed and followed up.Results(1)A Total 67 cases of fetal bronchopulmonary sequestration were diagnosed by ultrasound.The age of pregnant women ranged from 19 to 46 years,with a mean age of 30.1 years.All cases were diagnosed was in the middle stage of pregnancy,from 18 to 27 weeks.(2)Bronchopulmonary sequestration was found in 48 cases on the left side(71.6%),18 cases on the right side(26.9%),and 1 case on both sides(1.5%).Ten cases had cardiac displacement,among them,2 cases were accompanied by pleural effusion,abdominal effusion accompanied one case,pericardial effusion accompanied another case,systemic edema was present in one case,and increased amniotic fluid was noted in two cases.(3)45 cases were followed up,8 cases were terminated by induced abortion,37 cases were newborns,in which 1 died after birth and 36 survived.(4)Among the 37 newborns,there were 23 males and 14 females,34 full-term infants and 3 premature infants,and 2 cases of neonatal asphyxia.1 died due to congenital diaphragmatic hernia.1 had developmental delay with unknown causes.3 cases had respiratory symptoms after the neonatal period.14 cases underwent surgery,with the age range of 5 days to 30 months,and a median age of 11.5 months.When followed up to 2-10 years old,3 cases had respiratory symptoms.Conclusions Most children with bronchopulmonary sequestration have a good prognosis,and after prenatal diagnosis,regular follow-up and evaluation should be conducted during fetal,neonatal,and postnatal periods.

关 键 词：支气管肺隔离症 胎儿 预后 

分 类 号：R71[医药卫生—妇产科学]