胎儿脉络丛囊肿的产前诊断及预后临床分析

Clinical Analysis of Prenatal Diagnosis and Prognosis of Fetal Choroid Plexus Cysts

目的探讨患有脉络丛囊肿的胎儿产前诊断、预后和临床应用。方法从2011年1月—2013年12月选取49例孕中期经B超诊断为胎儿脉络丛囊肿的孕妇,检查胎儿的发育情况,记录产妇的妊娠结局及新生儿的生长发育情况。结果 49例脉络丛囊肿胎儿均在孕17~26周经B超诊断,囊肿直径为0.3~2.5 cm,双侧26例,单侧23例;孤立性40例,复杂性9例。染色体异常核型4例,占8.2%。23例单侧病变中,染色体异常1例。26例双侧病变中染色体异常3例。40例孤立性病变中染色体异常3例,9例复杂性病变中染色体异常1例。随访中活产43例,终止妊娠6例。43例活产儿中1例发现新生儿室间隔缺损,其余42例生长发育正常。结论染色体异常是导致胎儿脉络丛囊肿的重要原因;应该对孕妇进行产前染色体核型分析,避免严重缺陷的胎儿出生。要对脉络丛囊肿的胎儿进行全面检查,还要结合孕妇的年龄、孕周及家族史进行分析。

Objective To investigate the clinical application of prenatal diagnosis and prognosis of fetal choroid plexus cysts.Methods From January2011to December2013,49pregnant women were diagnosed by fetal ultrasonography and diagnosed with fetal choroid plexus cysts.The fetal development was followed by ultrasound.The outcome of followup pregnancy and the growth and development after fetal delivery were observed.Results The choroid plexus cysts in49fetuses were diagnosed at17to26weeks after ultrasonography.The diameter of cyst ranged from0.3to2.5cm,and26cases were bilateral.23cases was unilateral,40cases were isolated,9cases were complex.There were4cases with abnormal karyotypes,accounting for8.2%.There was1case of chromosomal abnormality in23unilateral lesions.There were3cases of chromosomal abnormalities in26cases of bilateral lesions.Of the40cases with solitary lesions,3had chromosomal abnormalities,and1case had chromosomal abnormalities in9cases with complex lesions.During follow-up,43live births and6terminated pregnancies.Ventricular septal defect was found in1of43live births,and the other42cases were normal growth and development.Conclusion Chromosomal abnormality is an important cause of fetal choriocystis cysts.Pregnant women should take prenatal diagnosis of chromosome karyotype analysis,to avoid serious defects in fetal birth.For choroid plexus cysts,a comprehensive examination is necessary,and the age of pregnant women,gestational age and family history should take into consideration.