肺头比在评估胎儿肺囊腺瘤样病变预后中的价值

Value of Congenital Cystic Adenomatoid Malformation Volume Ratio for Prognosis Evaluation in Fetal Congenital Cystic Adenmatiod Malformation of the Lung

目的:探讨肺头比(CVR)在胎儿肺囊腺瘤样病变(CCAM)预后评估中的价值。方法:分析本院2015年1月-2016年11月产前超声诊断为肺囊腺瘤样病变的胎儿共74例,均测量胎儿CVR,根据CVR测值分为CVR<1.6组66例及CVR≥1.6组8例,并追踪其临床预后。结果:74例肺囊腺瘤样病变胎儿中,CVR<1.6组孕期均无水肿出现,出生后均存活且无呼吸系统症状;CVR≥1.6组中5例(62.5%)合并胎儿水肿,7例(87.5%)出生后出现呼吸系统症状,6例存活,2例引产。两组胎儿产前水肿及出生后呼吸系统症状发生情况比较,差异均有统计学意义(P<0.01)。结论:肺囊腺瘤样病变不合并胎儿水肿时预后良好,CVR是产前评估胎儿肺囊腺瘤样病变预后的有效指标,CVR≥1.6与胎儿水肿及出生后出现症状相关。

Objective：To investigate the value of cystic volume ratio （ CVR ） for prognosis evaluation in fetal congenital cystic adenmatiod malformation （ CCAM ） ：Method： 74 cases with fetal CCAM diagnosed by prenatal ultrasound in our hospital from January 2015 to November 2016 were selected as objects.According to the measured value of CVR, they were divided into CVR〈1.6 group of 66 cases, and CVR≥ 1.6 group of 8 cases. The fetal CVR and their clinical prognosis were observed.Result： In 74 cases of fetal CCAM, there were no edema during pregnancy or respiratory symptoms after birth in CVR〈1.6 group.In CVR≥ 1.6 group, 5 cases （ 62.5% ） combined with fetal hydrops, 7 cases （ 87.5% ） with respiratory symptoms after birth, 6 patients survived, 2 cases of abortion.The differences of incidence of fetal hydrops and respiratory symptoms after birth between two groups were statistically significant （ χ2=34.13, 38.42, P〈0.01 ） .Conclusion： The prognosis of CCAM without fetal edema is good, CVR is a valid indicator of prenatal evaluation of fetal cystic adenomatoid lesions prognosis, CVR ≥ 1.6 related to fetal and postnatal symptoms.