胎儿腹腔囊性占位的生后治疗及转归

Prenatal diagnosis of the fetus with cystic abdominal mass and their clinical outcome after birth

目的分析产前诊断胎儿腹腔囊性占位的病因、随访、预后及转归，指导产前会诊咨询工作。方法收集2006年4月至2009年4月产前发现胎儿腹腔囊性占位的病例32例，分析病因、就诊年龄、占位大小、手术治疗效果及随访情况，总结预后与转归。结果32例患儿，男女比例为7：25，女性占绝对多数。新生儿期就诊23例，其余生后3个月内就诊。就诊时囊性占位较产前明显增大者7例（21．90／／00）。病因包括卵巢囊肿、畸胎瘤、肠源性囊肿、肾上腺来源性占位及胆总管囊肿。27例经I期手术预后良好。2例经Ⅱ期手术恢复良好。2例未行手术预后良好。1例因恶性肿瘤死亡。结论胎儿腹腔囊性占位以女性多见，以卵巢囊肿最多见。肠重复畸形、囊性畸胎瘤亦是常见病因。多数患儿因产前发现肿块在新生儿早期就诊。巨大腹腔囊性肿块造成消化道梗阻症状是早期就诊的主要原因。腹腔囊性占位的胎儿多数预后良好，转归满意。

Objective To summarize our experience with prenatal diagnosis of the fetus with cystic abdominal mass, and retrospectively analyze their clinical outcome after birth. Methods From April 2006 to April 2009, 32 fetuses were diagnosed with cystic abdominal mass in prenatal tests. Their clinical data including etiology, age at diagnosis, mass size, surgical treatment and follow-up were retrospectively analyzed. Results The 32 cases included 7 males and 25 females. Twenty three （71.9%） patients visited doctors in the neonatal period. The other patients （71.9%） visited doctors in the first 3 months after birth. The chief compliant was intestinal obstruction caused by abdominal mass. Seven patients＂ （21.9%） cystic abdominal masses enlarged after birth. The origins of the cystic abdominal masses were ovarian cysts, teratoma, enterogenous cysts, adrenal tumors and common bile duct cysts. Among the 32 patients, 27 patients underwent one stage tumor resection, and 2 were performed 2 stage surgery. Two patients didn＇t receive any surgery. And i patient with malignant tumor died. All patients recovered eventually from surgery. Conclusions Cystic abdominal mass in female fetus is more common than that in male fetus. The most common origin of cystic abdominal mass in female fetus is ovarian cysts. Intestinal duplication and cystic teratoma is also the common origins. Most neonates visit doctors for prenatal diagnosis of cystic abdominal mass. The prognosis of the majority of fetus with abdominal cyst is good.