2007～2012年佛山市胎儿先天性肺囊性腺瘤样畸形发病情况及妊娠结局临床分析

Clinical analysis on prevalence and pregnancy outcome of fetal congenital cystic adenomatoid malformation in Foshan from 2007 to 2012

目的：了解先天性肺囊性腺瘤样畸形（CCAM）患儿的发病情况、治疗过程、妊娠结局、产后随访,探讨影响妊娠结局的相关因素。方法：选取2007~2012年佛山市5个区分娩率较高的6家医院监测对象住院妊娠结局为流产（引产）或分娩的孕满9周至出生的死胎、活产儿中产前超声诊断为CCAM的患儿,运用卡方趋势检验分析CCAM患儿发病率及妊娠结局的变化趋势,运用多元Logistic回归分析CCAM患儿妊娠结局相关影响因素。结果：在152 166例孕妇中,产前超声诊断为CCAM共51例,发病率为3.34/万。2007~2009年CCAM患儿的妊娠结局以引产为主,2010~2012年以活产分娩为主,足月活产分娩CCAM患儿的并发症中肺炎发生率高于无特殊原因足月活产分娩的新生儿（P〈0.05）。在孕期或分娩期对患儿采取外科干预可以取得良好的治疗效果,随访示患儿情况良好。孕产妇的居住地、不良生育史及胎儿是否合并胸腹水等特殊情况是妊娠结局的影响因素。结论：先天性肺囊性腺瘤样畸形增加新生儿肺炎发生率,2007~2009年CCAM患儿的妊娠结局以引产为主,2010~2012年以活产分娩为主。孕产妇居住地在城市、有不良生育史及CCAM患儿病情轻是CCAM患儿活产分娩的保护因素。

Objective： To understand the prevalence, treatment, pregnancy outcome and postpartum visit of fetal congenital cystic adenomatoid malformation （ CCAM）, explore the related influencing factors of pregnancy outcome. Methods： The CCAM eases were selected from six hospitals in five districts of Foshan city from 2007 to 2012, Chi - square test for trend was used to analyze the change trends of morbidity and pregnancy outcome of CCAM cases, multivariate logistic regression analysis was used to analyze the related influencing factors of pregnancv outcome of CCAM eases. Results, Among 152 166 pregnant women, 51 cases were diagnosed as CCAM during prenatal diagnosis by uhrasonography, the incidence rate was 3.34/10 000. Themain pregnancy outcome of CCAM cases from 2007 to 2009 was induced abortion, while from 2010 to 2012, the main pregnancy outcome was live - birth delivery, the incidence rate of pneumonia among CCAM cases was statistically significantly higher than that among normal live birth neonates （P 〈 0. 05 ） . Surgical intervention could obtain good curative effect during pregnancy or delivery, follow - up showed good outcome. The influencing factors of pregnancy outcome included residence, abnormal pregnancy history and combing with hydrothorax and ascites or not. Conclusion： CCAM increases the incidence rate of neonatal pneumonia. The main pregnancy outcome of CCAM cases from 2007 to 2009 was induced abortion, while from 2010 to 2012, the main pregnancy outcome was live - birth delivery. The protective factors of live birth delivery of CCAM cases are living in city, having abnormal pregnancy history and mild degree of CCAM.