CAJ | 학술논문

目的：总结胎儿及新生儿先天性肺囊腺瘤样畸形的手术情况，初步比较两种手术的治疗结果。方法回顾性分析我们于2009年1月至2014年12月收治的13例先天性肺囊腺瘤样畸形患儿临床资料，均采取产时子宫外手术或新生儿期手术，术后均获得病理检查证实。按照手术方式将患儿分为两组，即胎儿手术组（n ＝6）、新生儿手术组（n ＝7），比较两组治疗结果。结果13例均存活，胎儿手术组与新生儿手术组手术时胎龄分别为（38．00±1．44）周、（39．27±1．42）周，P ＝0．138；出生体重分别为（3060．00±342．05）g、（3354．29±312．78）g，P ＝0．133；手术出血量分别为（8．67±6．38）mL、（6．29±3．04）mL，P ＝0．396；术后呼吸机支持天数分别为（3．67±1．75）d、（2．57±1．13）d，P ＝0．201；术后住院天数分别为（18．33±9．20）d、（11．43±2．43）d，P ＝0．081；差异均无统计学意义。肿物大小比较，P ＝0.000[（124．82±40．70）cm3 vs（23．76±5．84）cm3]；手术时间比较 P ＝0．000，[（43．16±6．6）min vs （92．86±24．58）min]，差异有统计学意义。结论产时子宫外处理技术可以作为治疗高风险的先天性肺囊腺瘤样畸形的方法之一，但手术风险大，操作复杂，需多学科合作，把握手术适应证，谨慎选择。
목적：총결태인급신생인선천성폐낭선류양기형적수술정황，초보비교량충수술적치료결과。방법회고성분석아문우2009년1월지2014년12월수치적13례선천성폐낭선류양기형환인림상자료，균채취산시자궁외수술혹신생인기수술，술후균획득병리검사증실。안조수술방식장환인분위량조，즉태인수술조（n ＝6）、신생인수술조（n ＝7），비교량조치료결과。결과13례균존활，태인수술조여신생인수술조수술시태령분별위（38．00±1．44）주、（39．27±1．42）주，P ＝0．138；출생체중분별위（3060．00±342．05）g、（3354．29±312．78）g，P ＝0．133；수술출혈량분별위（8．67±6．38）mL、（6．29±3．04）mL，P ＝0．396；술후호흡궤지지천수분별위（3．67±1．75）d、（2．57±1．13）d，P ＝0．201；술후주원천수분별위（18．33±9．20）d、（11．43±2．43）d，P ＝0．081；차이균무통계학의의。종물대소비교，P ＝0.000[（124．82±40．70）cm3 vs（23．76±5．84）cm3]；수술시간비교 P ＝0．000，[（43．16±6．6）min vs （92．86±24．58）min]，차이유통계학의의。결론산시자궁외처리기술가이작위치료고풍험적선천성폐낭선류양기형적방법지일，단수술풍험대，조작복잡，수다학과합작，파악수술괄응증，근신선택。
Objetive To compare the surgical results of congenital cystic adenomatoid malformation of lung in fetus and that in neonate. Methods A retrospective analysis was made on 13 cases of clinical data and surgical results with congenital cystic adenomatoid Malformation of lung in our hospital during Jan.2010 to Dec.2014.The patients were divided by surgical approach into two groups:ex utero intrapartum treatment and neonatal surgery:fetal surgery group (n =6),neonatal surgery group (n =7). Results All 13 patients sur-vived.There were no statistically significant difference between two groups in the following aspects:Gestational age (38.00 ±1.44 weeks vs 39.27 ±1.42 weeks,P =0.138);birth weight (3060.00 ±342.05 g vs 3 354.29 ±312.78 g,P =0.133),surgical bleeding (8.67 ±6.38 mL vs 6.29 ±3.04 mL,P =0.396),the breathing machine support after the operation (3.67 ±1.75 d vs 2.57 ±1.13 d,P =0.201),hospitalization time after the operation (18.33 ±9.20 vs 11.43 ±2.43 d,P =0.081 ).And there were statistically significant differ-ences in the following aspects:Tumor size (124.82 ±40.70 cm3 vs 23.76 ±5.84 cm3 ,P =0.000);Operative time (43.16 ±6.6 min vs 92.86 ±24.58 min,P =0.000). Conclusions The Ex utero intrapartum treatment is a favorable therapeutic approach for those fetuses with congenital cystic adenomatoid malformation which lead to persistent cardiac and mediastinal compression.