胎儿胸腔异常的超声诊断及随访

Ultrasonic diagnosis and follow-up of fetal pleural abnormalities

目的分析胎儿常见胸腔异常的产前超声诊断及随访结果。方法回顾性分析28例胎儿胸腔异常声像图特征,并与病检、随访结果对照,将其引产率与同期所有胎儿结构畸形的引产率对照分析。结果 109例胎儿结构畸形中引产65例,引产率为59.6%;28例胸腔异常回声病例中引产5例,引产率为17.9%,两种情况引产率差异有统计学意义(P<0.05)。产前诊断28例胎儿胸腔异常,其中8例为膈疝,先天性肺囊腺瘤9例,隔离肺5例,隔离肺与肺囊腺瘤的混合病灶1例,胸腔积液5例。随访结果 21例活产,其中7例病变在产前复查自然消失;5例引产,2例出生后死亡。结论常见胎儿胸腔异常的特征性超声图像可作为诊断的重要线索,部分胸腔异常病灶有自然消退的可能。强调对有胸腔异常的胎儿进行动态观察,从而明确疾病转归。

Objective To analyze prenatal ultrasonic diagnosis and follow-up results of fetal pleural abnormalities.Methods The ultrasonographic features of 28 fetuses with pleural abnormalities were retrospectively analyzed,then the results were compared with pathological examination and follow-up results.The induced abortion rate of these fetuses were compared with the induced abortion rate of cases with fetal structural abnormalities during the same period.Results Among 109 cases with fetal structural abnormalities,65 cases underwent induced abortion,the induced abortion rate was 59.6%;among 28 cases with fetal pleural abnormalities,5 cases underwent induced abortion,the induced abortion rate was 17.9%,there was statistically significant difference（P〈0.05）.Among 28 cases with fetal pleural abnormalities,8 cases were found with diaphragmatic hernia,9 cases were found with congenital lung cystadenoma,5 cases were found with pulmonary sequestration,1 case was found with pulmonary sequestration combined with congenital lung cystadenoma,and 5 cases were found with pleural effusion.Twenty-one cases were alive during follow-up,the lesions of 7 cases disappeared before prenatal reexamination;5 cases underwent induced abortion,and 2 cases died after birth.Conclusion The common ultrasonographic features of fetal pleural abnormalities can be used as important clues for diagnosis,partial lesions disappear naturally,dynamic observation of the fetuses with pleural abnormalities can determine prognosis of the disease.