CAJ | 학술논문

目的：讨论胎儿先天性支气管囊肿的诊断和早期干预治疗。方法回顾性分析广东省妇幼保健院2013年1月至2014年5月诊断为胎儿先天性支气管囊肿7例患儿的临床特征，结合出生后 CT 以及手术、病理检查，分析胎儿先天性支气管囊肿的产前诊断和出生后的治疗经验。结果在胎儿产前超声影像和出生后 CT 及手术病理的基础上，共有7例支气管囊肿患儿得到确诊。其中4例产前诊断为肺囊腺瘤，3例产前诊断为胎儿支气管囊肿，产前超声诊断准确率为42.9%（3/7例）。出生后行 CT 检查并手术，7例均经胸腔入路行囊肿切除，手术年龄为（5.3±1.7）个月。手术方式分别为支气管囊肿切除4例，支气管囊肿＋肺囊腺瘤切除2例，支气管囊肿＋隔离肺切除1例。术中确诊支气管囊肿4例，合并先天性肺囊腺瘤2例，合并先天性肺隔离症1例。出生后 CT 诊断准确率为85.7%（6/7例）。所有手术治疗患儿均治愈。结论胎儿支气管囊肿多伴肺部先天性畸形，产前诊断胎儿支气管囊肿存在一定困难，尤其需要与肺囊腺瘤鉴别，为避免出现压迫、感染症状，产前诊断＋出生后 CT 检查＋早期手术的治疗模式是值得推荐的诊疗模式。
목적：토론태인선천성지기관낭종적진단화조기간예치료。방법회고성분석광동성부유보건원2013년1월지2014년5월진단위태인선천성지기관낭종7례환인적림상특정，결합출생후 CT 이급수술、병리검사，분석태인선천성지기관낭종적산전진단화출생후적치료경험。결과재태인산전초성영상화출생후 CT 급수술병리적기출상，공유7례지기관낭종환인득도학진。기중4례산전진단위폐낭선류，3례산전진단위태인지기관낭종，산전초성진단준학솔위42.9%（3/7례）。출생후행 CT 검사병수술，7례균경흉강입로행낭종절제，수술년령위（5.3±1.7）개월。수술방식분별위지기관낭종절제4례，지기관낭종＋폐낭선류절제2례，지기관낭종＋격리폐절제1례。술중학진지기관낭종4례，합병선천성폐낭선류2례，합병선천성폐격리증1례。출생후 CT 진단준학솔위85.7%（6/7례）。소유수술치료환인균치유。결론태인지기관낭종다반폐부선천성기형，산전진단태인지기관낭종존재일정곤난，우기수요여폐낭선류감별，위피면출현압박、감염증상，산전진단＋출생후 CT 검사＋조기수술적치료모식시치득추천적진료모식。
Objective To discuss the diagnosis and early intervention treatment of fetal congenital broncho-genic cysts based on the cases reviewed. Methods The clinical features of 7 infants presenting bronchogenic cysts diagnosed antenatally from January 2013 to May 2014 in Guangdong Women and Children's Hospital and Health In-stitute were reviewed retrospectively. Pathology,the prenatal diagnosis and treatment of bronchogenic cysts experience were summarized combined with CT after birth and surgery. Results Based on the prenatal diagnosis of fetal and postnatal CT and surgical pathology,a total of 7 cases with congenital bronchial cysts were diagnosed. Of which 4 ca-ses were suggestive of congenital cystsic adenomatoid malformation by prenatal diagnosis,and the other 3 cases had fetal bronchial cysts by prenatal diagnosis,antenatal diagnosis was accurate in 42. 9%(3 / 7 cases). CT examinations were taken in 7 cases after birth,and the cyst excision was performed on them with surgery thoracic approach;the average age at surgery was(5. 3 ± 1. 7)months. Four cases had simple bronchial cystss,2 cases with congenital cystsic adenomatoid malformation,1 case with congenital pulmonary sequestration. The accuracy of CT diagnosis was 85. 7%(6 / 7 cases). All surgical treatment was effective. Conclusions Fetal bronchial cysts is always associated with the other presence of lung congenital malformations. Prenatal diagnosis of congenital bronchial cysts is difficult. Prenatal diagnosis is difficult to exclude congenital cystsic adenomatoid malformation. To avoid symptoms like oppres-sion,infection,prenatal diagnosis combined with CT examination after birth and early treatment are necessary and reliable clinically.