摘要
目的探讨消化道畸形的胎儿超声征象与新生儿的临床特征。方法 35例出生后经影像学检查或开腹手术确诊的消化道畸形病例进行产前超声、生后临床特征的回顾性分析。结果 35例消化道畸形包括食道闭锁6例,环状胰腺6例,VECTERL综合征3例,胎粪性腹膜炎4例,小肠重复畸形合并肠系膜裂孔疝1例,肠闭锁7例,肠旋转不良1例,巨结肠2例,肛门直肠异常5例。其中2例肛门直肠闭锁合并多发畸形,1例食道闭锁患儿合并21-三体综合征。产前超声声像图异常27例,正常8例。产前超声异常图像包括羊水过多14例,双泡征5例,腹腔内囊性结构1例,肠管增宽3例,膀胱下方无回声1例,单脐动脉3例,胃泡小4例,肠管回声增强2例,腹腔积液2例,腹腔占位1例。临床表现包括呕吐12例,腹胀10例,排便异常5例,腹痛1例,皮肤苍白1例。随访35例患儿,1例行内科治疗存活,28例行手术治疗,其中26例存活,2例手术后放弃,其余6例放弃未治疗。结论产前超声对预测胎儿消化道畸形有帮助,但不是所有消化道畸形产前都有异常表现。生后表现呕吐、腹胀、排便异常、腹痛、皮肤苍白的新生儿需警惕消化道畸形,及时行相关检查。
Objective：To approach prenatal ultrasound signs and the clinical characteristics of neonates with congenital digestive tract malformation. Methods：Thirty-five cases of congenital digestive tract malformation who were diagnosis after birth were enrolled in the study. Prenatal ultrasound signs,and clinical characteristics were retrospectively analyzed. Results：Six presented with esophagus atresia（one complicated with 21-trisome syndrome）,Six with annular pancreas,Three with VECTERL symptom complex,four with meconium peritonitis,one with duplication of intestine to combine mesenteric hiatal hernia,seven with intestinal atresia,one with malrotation of intestine,two with congenital giant-colon,five with anorectal anomaly（two complicated with multiple malformations）. Abnormal relative signs were found by ultrasound in twenty-seven cases. Among them,fourteen cases had hydramnios,five had double bubble sign,one had cystic mass,three had intestinal dilation, one had echoless,three had single umbilical artery,four had small aerogastria,two had hyperechogenic bowel,two had seroperitoneum,one had pseudocyst Vomiting,abdominal distension and delayed passing of meconium were the major clinical manifestations with respective cases of twelve,ten and five. Besides,one presented with abdominal pain,one with ochrodermia. One neonate with medical treatment survived,Two cases abandoned treatment after surgery. six neonate survived. Twenty-seven case survived after surgery. Conclusions：Prenatal ultrasound is helpful in detecting fetal congenital digestive tract malformation,but it has some limits. The neonates with Vomiting,abdominal distension,delayed passing of meconium,abdominal pain and ochrodermia are thought of highly.
出处
《中国优生与遗传杂志》
2016年第5期110-113,共4页
Chinese Journal of Birth Health & Heredity
关键词
消化道畸形
产前超声征象
临床表现
Congenital digestive tract malformation
Prenatal ultrasound signs
Clinical feature
