摘要
目的分析新生儿外科性疾病的产前诊断现状，探讨产前诊断对新生儿外科疾病转归的影响。方法2004年2月～2006年7月，产前多科会诊465例，进行胎儿及新生儿随访。分析产前会诊疾病分类，比较产前诊断新生儿外科性疾病与生后诊断的符合率，探讨产前诊断后胎儿处理对新生儿外科造成的影响作用。结果产前会诊465例中胎儿因素占395例（84．9％），外科性疾病315例，占79．7％（315／395）。395例中125例选择人工流产，占31．6％；32例新生儿生后2个月内接受手术，16例生后新生儿死亡。胎儿会诊疾病中占据前5名的为泌尿系异常73例（18．5％）、脑部异常包括脑室扩张和脉络膜囊肿60例（15．2％）、多发畸形42例（10．6％）、宫内感染包括宫内发育迟缓39例（9．9％）和心脏畸形32例（8．1％）。腹裂、脐膨出、膈疝、胸部占位性病变（肺纤维囊性变）和颈部巨大淋巴管瘤的人工流产终止妊娠率均高于50％。结论产前会诊中新生儿外科疾病占多数，产前诊断后部分新生儿外科疾病人工流产率较高。产前诊断的胎儿肾盂扩张或脑室扩张，随访中有较高的消退率和〈15％的新生儿手术率。
Objective To review the outcome of antenatal diagnosis on neonatal surgery. Methods We reviewed 465 pregnant women who underwent antenatal examination in our hospital between February 2004 and July 2006. Fetuses were followed up postnatally. We classified the diseases and compared antenatal and postnatal diagnoses. Results Of 465 cases consulted, 395 fetuses were abnormal Surgical diagnoses accounted for 315 out of 395 of the cases （79.7%）. One hundred and twenty five pregnant women chose abortion after the diagnoses. 31.6% （32） babies underwent operations within 2 months. Sixteen newborns died after birth. The top five most common diagnoses were urological anomalies （18.5 %）, brain anomalies （15.2 %）, multiple malformations （10. 6 %）, infections （9. 9%） and congenital heart disease （8. 1%）. With the diagnoses of gastroschisis, omphalocele, diaphragmatic hernia, lung disease and neck huge lymphaugioma, more than half of mothers chose abortion. Conclusions Fetal surgical condition is the most antenatal diagnosis. It is associated with high abortion rate. Fetal hydronephrosis and hydrocephalus are common and have high rates of spontaneous remission and less than 15% of them require operations.
出处
《中华小儿外科杂志》
CSCD
北大核心
2007年第3期113-116,共4页
Chinese Journal of Pediatric Surgery
基金
上海医学领军人才项目资助（编号：LJ06055）
关键词
产前诊断
新生儿疾病和畸形
外科手术
临床观察
Antenatal diagnosis
Neonatal disease and abnormalities
Surgical procedures
