中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
14期
1090-1092
,共3页
先天性胸腔积液%胎儿及新生儿%病因%诊断%治疗
先天性胸腔積液%胎兒及新生兒%病因%診斷%治療
선천성흉강적액%태인급신생인%병인%진단%치료
Congenital pleural effusion%Fetal and neonatal%Etiology%Diagnosis%Treatment
目的：探讨胎儿及新生儿先天性胸腔积液的病因、临床特点及诊断和治疗，以提高临床医师对该病的认识。方法回顾性分析郑州大学第一附属医院新生儿科的6例先天性胸腔积液患儿的临床资料，结合文献复习分析其病因、临床特点及相关诊断和治疗过程。结果6例先天性胸腔积液患儿中，乳糜胸3例，其中1例同时合并乳糜腹、21-三体综合征、先天性甲状腺功能低下，病因不明者3例。确诊主要靠影像学和实验室检查。胸、腹水体液有核细胞数（1588~13057）×106/ L，以淋巴细胞为主；蛋白定性均阳性（＋~＋＋＋）；乳糜定性实验阳性3例；肝功能示均有不同程度的总蛋白及清蛋白降低。根据患儿情况采取内科保守治疗或外科治疗，其中3例治疗好转后出院，另外3例最终放弃治疗。结论先天性胸腔积液病因很多，常合并染色体异常或其他畸形，超声检查是产前诊断的主要手段，对产前即发现胸腔积液的患儿可动态观察，必要时于产前或产时行宫内治疗，故早期诊断与治疗十分重要。
目的：探討胎兒及新生兒先天性胸腔積液的病因、臨床特點及診斷和治療，以提高臨床醫師對該病的認識。方法迴顧性分析鄭州大學第一附屬醫院新生兒科的6例先天性胸腔積液患兒的臨床資料，結閤文獻複習分析其病因、臨床特點及相關診斷和治療過程。結果6例先天性胸腔積液患兒中，乳糜胸3例，其中1例同時閤併乳糜腹、21-三體綜閤徵、先天性甲狀腺功能低下，病因不明者3例。確診主要靠影像學和實驗室檢查。胸、腹水體液有覈細胞數（1588~13057）×106/ L，以淋巴細胞為主；蛋白定性均暘性（＋~＋＋＋）；乳糜定性實驗暘性3例；肝功能示均有不同程度的總蛋白及清蛋白降低。根據患兒情況採取內科保守治療或外科治療，其中3例治療好轉後齣院，另外3例最終放棄治療。結論先天性胸腔積液病因很多，常閤併染色體異常或其他畸形，超聲檢查是產前診斷的主要手段，對產前即髮現胸腔積液的患兒可動態觀察，必要時于產前或產時行宮內治療，故早期診斷與治療十分重要。
목적：탐토태인급신생인선천성흉강적액적병인、림상특점급진단화치료，이제고림상의사대해병적인식。방법회고성분석정주대학제일부속의원신생인과적6례선천성흉강적액환인적림상자료，결합문헌복습분석기병인、림상특점급상관진단화치료과정。결과6례선천성흉강적액환인중，유미흉3례，기중1례동시합병유미복、21-삼체종합정、선천성갑상선공능저하，병인불명자3례。학진주요고영상학화실험실검사。흉、복수체액유핵세포수（1588~13057）×106/ L，이림파세포위주；단백정성균양성（＋~＋＋＋）；유미정성실험양성3례；간공능시균유불동정도적총단백급청단백강저。근거환인정황채취내과보수치료혹외과치료，기중3례치료호전후출원，령외3례최종방기치료。결론선천성흉강적액병인흔다，상합병염색체이상혹기타기형，초성검사시산전진단적주요수단，대산전즉발현흉강적액적환인가동태관찰，필요시우산전혹산시행궁내치료，고조기진단여치료십분중요。
Objective To discuss the etiology,clinical features,diagnosis and treatment of congenital pleural effusion in fetuses and neonates in order to improve the understanding of this disease. Methods Six neonate cases with congenital pleural effusion were retrospectively analyzed in neonates who were admitted to the Department of Neonatolo-gy of the First Affiliated Hospital of Zhengzhou University after birth and the etiology,clinical features,diagnosis and re-lated treatment were analyzed based on literature review. Results Among 6 patients with congenital pleural effusion, chylothorax was found in 3 cases,one of whom had chylothorax,chylous abdominal,21 trisomy syndrome and congenital hypothyroidism,and the etiology of the other 3 cases were unknown. Diagnosis mainly was depended on imaging and la-boratory tests. The number of nucleated cells of hydrothorax or ascites were(1 588 - 13 057)× 106 / L,mainly lympho-cytes. Protein qualitative was( + - + + + ),the chylothorax qualitative test was positive in 3 cases. The liver function showed that the total protein and albumin were decreased in varyig degrees. Conservative or surgical treatment was taken according to the situation of the patients. Among 6 patients,3 cases were cured after treatment,the others gave up treat-ment finally. Conclusions The etiology of congenital pleural effusion was different,and often associated with chromo-somal abnormalities or other malformations,ultrasonography was the main method to diagnose congenital pleural effusion and the patients should be dynamically observed or treated during the antepartum or intrapartum period. If the neonates are found to have pleural effusion in prenatal period early diagnosis and treatment is a best choice.
