CAJ | 학술논문

目的了解胎儿腹部肿块的产前超声评估的准确性、肿块发展的特点和家属对胎儿腹部肿块的选择状况。方法复习3年来发现的胎儿腹部肿块病例的临床资料，记录肿块发现时的胎龄、位置大小、肿块特征（囊性、实性、混合性）、产前初步诊断、出生前超声随访、家属对有腹部肿块胎儿的选择、出生后诊断、治疗随访等项目。结果共发现胎儿腹部肿块59例，腹部肿块占同期全部产前发现异常病例（身体各部畸形或肿瘤）的2.2％(59/2 723)。胎龄最小20周，最大39周，平均31.3周。其中37例获尸检、生后手术或影像学证实，3例与产前诊断不符，总符合率为91.9％；肿块临产前或生后缩小消失18例（18/59，诊断明确3例，未明确15例）；家属未采纳医生意见而选择引产19例(19/59)，引产未尸检及失访共21例(21/59)。实际（经手术证实）或根据影像学检查结果推测发现肿瘤40例。结论胎儿腹部肿块较易在产前超声检查中发现，产前诊断多数能与生后诊断相符合。大多数病例自然病程及预后较为良好，即能自行消退，或生后诊断明确后或当发现肿块增大时及时手术治疗。当获知胎儿存在肿瘤可能后，相当部分的家属会选择终止妊娠。
목적 료해태인복부종괴적산전초성평고적준학성、종괴발전적특점화가속대태인복부종괴적선택상황。방법 복습3년래발현적태인복부종괴병례적림상자료，기록종괴발현시적태령、위치대소、종괴특정（낭성、실성、혼합성）、산전초보진단、출생전초성수방、가속대유복부종괴태인적선택、출생후진단、치료수방등항목。결과 공발현태인복부종괴59례，복부종괴점동기전부산전발현이상병례（신체각부기형혹종류）적2.2％(59/2 723)。태령최소20주，최대39주，평균31.3주。기중37례획시검、생후수술혹영상학증실，3례여산전진단불부，총부합솔위91.9％；종괴임산전혹생후축소소실18례（18/59，진단명학3례，미명학15례）；가속미채납의생의견이선택인산19례(19/59)，인산미시검급실방공21례(21/59)。실제（경수술증실）혹근거영상학검사결과추측발현종류40례。결론 태인복부종괴교역재산전초성검사중발현，산전진단다수능여생후진단상부합。대다수병례자연병정급예후교위량호，즉능자행소퇴，혹생후진단명학후혹당발현종괴증대시급시수술치료。당획지태인존재종류가능후，상당부분적가속회선택종지임신。
Objective To assess the accuracy of prenatal diagnosis in abdominal masses, natural development of the mass and the status of parent's choice for termination. Methods Clinical data of prenatally ultrasonographic diagnosed abdominal masses in recent 3 years were reviewed, including gestation age, mass size and location, mass features (cystic, mixed, solid), prenatal diagnosis, prenatal follow-up, the parents' choice for termination, postnatal diagnosis and management and follow-up.Results A total of 59 fetal abdominal masses were found. They accounted for 2. 2 ％ among the prenatally diagnosed malformation and tumors(59/2723)in same period. Of these cases, the youngest was 20 weeks and the oldest 39 weeks. Mean gestation age is 31.3 weeks. Confirmed diagnosis from autopsy, postnatal operation and image examination was gained. Only 3 cases were not match to the prenatal diagnosis. The total accordance is 91.9％. The masses presented regression before or after birth were observed in 18 cases (18/59, 3 confirmed and 15 not confirmed). Ninteen parents(19/59) refused the physician's advice and chose termination. Twenty-one (21/59) were termination without autopsy and lost follow-up. Fifty tumors diagnosed via operation or postnatal image examination were established. Conclusions Fetal abdominal mass can be found by sonography. Most prenatal diagnosis is match to postnatal result. The natural history of fetal mass is favorable. Some parents may choose termination when they know the fetal with suspected tumor in China.