产前辅助检查对诊断先天性膈疝及其预后评价的研究进展

Progress in prenatal examinations for diagnosis and prognostic evaluation of congenital diaphragmatic hernia

先天性膈疝（congenitaldiaphragmatichernia，CDH）是由于膈肌发育不全，腹腔内容物进入胸腔，从而引起一系列病理生理变化的一种疾病。由于CDH患儿的病死率高、预后差，因此，越早诊断越有利于产前干预和出生后治疗。目前，对于CDH，产前超声筛查是最常用的检查方法，具有方便、经济的特点；MRI可以同时评价肺发育程度和肺成熟度，可以作为超声检查的必要补充；胎儿超声心动图是近年来开展的检查方法，通过观察血流动力学及肺血管发育情况，从而提示预后。

Congenital diaphragmatic hernia （CDH） is caused by unilateral or bilateral diaphragmatic hypoplasia allowing abdominal organs to move into the thoracic, resulting in a series of pathophysiological changes, high mortality and poor prognosis. Therefore, earlier diagnosis is conducive to prenatal intervention and postnatal treatment. At present, prenatal ultrasonography is the most common used examination for CDH due to its convenience and low cost. MRI is complementary to ultrasound examination as it can evaluate both pulmonary development and maturity. Fetal echocardiography is a newly developed method in recent years which helps to indicate the prognosis through observation of hemodynamics and pulmonary vessels development.