本文選題：胎兒肺囊腺瘤樣畸形(CCAM)　切入點：肺隔離癥(BPS)　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討先天性肺囊腺瘤樣畸形(CCAM)和肺隔離癥(BPS)胎兒的妊娠結(jié)局以及類固醇激素治療情況,為遺傳咨詢、優(yōu)生優(yōu)育提供臨床建議。方法:臨床回顧性分析2006年1月至2016年12月因胎兒CCAM和BPS在我院產(chǎn)前診斷中心就診的17例單胎孕婦和其中接受治療的7例孕婦,隨訪并分析產(chǎn)前診斷結(jié)果、妊娠結(jié)局、激素治療情況及新生兒出生情況。檢索PubMed、Embase、CNKI及WanFang Data數(shù)據(jù)庫中關(guān)于激素治療胎兒CCAM和BPS的文獻,進行系統(tǒng)回顧分析。結(jié)果:就診的17例孕婦中,2例胎兒染色體異常,其中1例9號染色體臂間倒位繼續(xù)妊娠。余胎兒染色體正常的孕婦中,1例失訪,2例自行引產(chǎn)。繼續(xù)妊娠的13例孕婦中,6例CVR1.6,無合并癥,足月分娩存活。7例因CVR1.6或胎兒水腫予激素治療,結(jié)果:胎兒存活率71.43%,水腫胎兒存活率33.33%,剖宮產(chǎn)率20%,均足月分娩。系統(tǒng)評價部分,納入8篇文章,共97個對象。經(jīng)治療后胎兒存活率、腫塊減小率分別為53%~100%、62%~100%。合并水腫的胎兒,治療后水腫好轉(zhuǎn)率54%~100%,存活率46~80%。研究中,剖宮產(chǎn)率為18%~60%,早產(chǎn)發(fā)生率為9%~27%,匯總分析后,其剖宮產(chǎn)率28.9%,早產(chǎn)率18.4%。在亞組分析中,單療程組在胎兒存活率和水腫緩解率方面與多療程組相比,無統(tǒng)計學(xué)差異。結(jié)論:胎兒CCAM和BPS屬解剖結(jié)構(gòu)異常,建議行胎兒染色體核型分析產(chǎn)前診斷。對于高危的CCAM和BPS胎兒,應(yīng)用激素可改善胎兒預(yù)后,且不增加剖宮產(chǎn)率,但早產(chǎn)率較總體比例升高。此外,單療程與多療程的療效相比無明顯差異,對單療程無效胎兒的下步診療也需進一步探討。
[Abstract]:Objective: to investigate the pregnancy outcome and steroid hormone therapy of congenital cystadenomatoid malformation (CCAM) and pulmonary sequestration (BPSS) fetus for genetic counseling. Methods: from January 2006 to December 2016, 17 single born pregnant women and 7 pregnant women receiving treatment due to fetal CCAM and BPS in our hospital were analyzed retrospectively. The results of prenatal diagnosis, pregnancy outcome, hormone therapy and newborn birth were followed up and analyzed. Literature on hormone therapy for fetal CCAM and BPS were searched in PubMedbase Data and WanFang Data database. Results: of the 17 pregnant women, 2 had fetal chromosomal abnormalities. Among them, 1 case continued pregnancy with chromosome 9 interarm inversion, 1 case with normal fetal chromosome, 1 case lost and 2 cases spontaneous induced labor, and 6 cases of CVR 1.6 in 13 cases of continuous pregnancy, no complication, no complication, no complication, no complication, no complication, no complication, no complication, no complication, no complication, no complication, no complication, and no complication. Seven cases of full-term delivery were treated with hormone because of CVR1.6 or fetal edema. Results: fetal survival rate was 71.43%, edema fetus survival rate was 33.33%, cesarean section rate 20%, term delivery. After treatment, the survival rate of the fetus and the reduction rate of the mass were 53% and 100%, respectively. The fetus with edema, the edema improvement rate after treatment was 54 ~ 100 and the survival rate was 46 ~ 80. In the study, the cesarean section rate was 180.The incidence rate of premature delivery was 92727. The cesarean section rate was 28.9 and the premature delivery rate was 18.4.In the subgroup analysis, there was no significant difference in fetal survival rate and edema relief rate between the single course group and the multi-course group. Conclusion: fetal CCAM and BPS belong to abnormal anatomical structure. Prenatal diagnosis of fetal chromosomal karyotype analysis is recommended. For high-risk CCAM and BPS fetuses, the use of hormones can improve the fetal prognosis without increasing the cesarean section rate, but the premature delivery rate is higher than the overall rate. There was no significant difference between single course of treatment and multi course of treatment.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R714.5

【參考文獻】

相關(guān)期刊論文 前10條

1 蔣芳;高勁松;鐘逸鋒;胡靜;楊劍秋;馬良坤;劉俊濤;;北京協(xié)和醫(yī)院25年早產(chǎn)狀況的調(diào)查[J];中國醫(yī)學(xué)科學(xué)院學(xué)報;2016年05期

2 王展;唐達星;;胎兒骶尾部畸胎瘤的預(yù)后評估研究進展[J];中華小兒外科雜志;2016年09期

3 王小蘭;張寧;吳寶萍;張云鶴;李廣太;;單絨毛膜性雙胎選擇性宮內(nèi)生長受限的研究進展[J];重慶醫(yī)學(xué);2016年25期

4 馮威;劉文英;;胎兒外科及產(chǎn)時外科進展[J];實用醫(yī)院臨床雜志;2016年04期

5 劉彩霞;于文倩;;胎兒外科手術(shù)現(xiàn)狀及展望[J];中國實用婦科與產(chǎn)科雜志;2016年01期

6 劉文英;;開展胎兒外科與產(chǎn)時外科的前景及意義[J];中華婦幼臨床醫(yī)學(xué)雜志(電子版);2015年06期

7 夏薇;夏風;劉芳;蘭為順;余旭東;歐陽偉;蘇永學(xué);李琳;袁先宏;楊文忠;陳欣林;;胎兒肺隔離癥超聲與磁共振診斷應(yīng)用分析[J];中華醫(yī)學(xué)超聲雜志(電子版);2015年05期

8 郭曉玲;鄧璐莎;鐘進;伍秋艷;王婷;;胎兒宮內(nèi)輸血的臨床應(yīng)用[J];中國婦幼保健;2015年06期

9 王學(xué)舉;熊光武;魏瑗;原鵬波;趙揚玉;;胎兒鏡激光凝固胎盤吻合血管術(shù)治療44例雙胎輸血綜合征臨床分析[J];中華婦產(chǎn)科雜志;2014年12期

10 楊小紅;陳欣林;戢秀勤;楊菁;;雙胎反向動脈灌注序列征的研究進展[J];中華醫(yī)學(xué)超聲雜志(電子版);2014年05期

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