中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
Chinese Journal of Clinicians (Electronic Edition)
2015年
20期
3714-3719
,共6页
李姣玲%颜璨%耿秀平%张蕊
李姣玲%顏璨%耿秀平%張蕊
리교령%안찬%경수평%장예
超声检查,产前%胎儿%消化道梗阻%围产期结局
超聲檢查,產前%胎兒%消化道梗阻%圍產期結跼
초성검사,산전%태인%소화도경조%위산기결국
Ultrasonography,prenatal%Fetus%Digestive tract obstruction%Perinatal outcome
目的：探讨先天性消化道梗阻产前超声声像图特征，回顾性分析其围产期结局。方法收集产前超声诊断为消化道梗阻胎儿的完整资料，与产后新生儿特殊检查及手术结果或引产后尸体解剖及病理检查结果相比较，分析总结其产前超声声像图特征，并对其羊水或脐血染色体检测结果进行分析，新生儿随访至出生后1个月，追踪其围产期结局。结果本组70278例胎儿中超声拟诊87例消化道梗阻胎儿（2例结肠一过性扩张误诊为结肠梗阻，产后腹部平片未见异常），消化道梗阻检出率为0.1%（85/70278）；漏诊1例乙状结肠闭锁（产后手术证实），超声诊断消化道梗阻的诊断符合率为98.8%（85/86）。86例消化道梗阻胎儿伴发染色体异常21例，染色体异常发生率为24.4%（21/86），其中包括5例食管狭窄或闭锁，8例十二指肠狭窄或闭锁，4例小肠狭窄或闭锁，3例结肠狭窄或闭锁，1例肛门闭锁。62例单一消化道梗阻伴发染色体异常7例，染色体异常发生率为11.3%（7/62），24例消化道梗阻合并其他结构畸形伴发染色体异常14例，染色体异常发生率为58.3%（14/24），二者比较，差异有统计学意义（U=20.7，P＜0.005）。结论消化道不同部分梗阻具有其特殊超声声像图表现，围产期结局与梗阻部位以及是否合并其他畸形有关；消化道梗阻胎儿染色体异常发生率较高，合并其他结构畸形时染色体异常发生率显著高于单一消化道梗阻胎儿。
目的：探討先天性消化道梗阻產前超聲聲像圖特徵，迴顧性分析其圍產期結跼。方法收集產前超聲診斷為消化道梗阻胎兒的完整資料，與產後新生兒特殊檢查及手術結果或引產後尸體解剖及病理檢查結果相比較，分析總結其產前超聲聲像圖特徵，併對其羊水或臍血染色體檢測結果進行分析，新生兒隨訪至齣生後1箇月，追蹤其圍產期結跼。結果本組70278例胎兒中超聲擬診87例消化道梗阻胎兒（2例結腸一過性擴張誤診為結腸梗阻，產後腹部平片未見異常），消化道梗阻檢齣率為0.1%（85/70278）；漏診1例乙狀結腸閉鎖（產後手術證實），超聲診斷消化道梗阻的診斷符閤率為98.8%（85/86）。86例消化道梗阻胎兒伴髮染色體異常21例，染色體異常髮生率為24.4%（21/86），其中包括5例食管狹窄或閉鎖，8例十二指腸狹窄或閉鎖，4例小腸狹窄或閉鎖，3例結腸狹窄或閉鎖，1例肛門閉鎖。62例單一消化道梗阻伴髮染色體異常7例，染色體異常髮生率為11.3%（7/62），24例消化道梗阻閤併其他結構畸形伴髮染色體異常14例，染色體異常髮生率為58.3%（14/24），二者比較，差異有統計學意義（U=20.7，P＜0.005）。結論消化道不同部分梗阻具有其特殊超聲聲像圖錶現，圍產期結跼與梗阻部位以及是否閤併其他畸形有關；消化道梗阻胎兒染色體異常髮生率較高，閤併其他結構畸形時染色體異常髮生率顯著高于單一消化道梗阻胎兒。
목적：탐토선천성소화도경조산전초성성상도특정，회고성분석기위산기결국。방법수집산전초성진단위소화도경조태인적완정자료，여산후신생인특수검사급수술결과혹인산후시체해부급병리검사결과상비교，분석총결기산전초성성상도특정，병대기양수혹제혈염색체검측결과진행분석，신생인수방지출생후1개월，추종기위산기결국。결과본조70278례태인중초성의진87례소화도경조태인（2례결장일과성확장오진위결장경조，산후복부평편미견이상），소화도경조검출솔위0.1%（85/70278）；루진1례을상결장폐쇄（산후수술증실），초성진단소화도경조적진단부합솔위98.8%（85/86）。86례소화도경조태인반발염색체이상21례，염색체이상발생솔위24.4%（21/86），기중포괄5례식관협착혹폐쇄，8례십이지장협착혹폐쇄，4례소장협착혹폐쇄，3례결장협착혹폐쇄，1례항문폐쇄。62례단일소화도경조반발염색체이상7례，염색체이상발생솔위11.3%（7/62），24례소화도경조합병기타결구기형반발염색체이상14례，염색체이상발생솔위58.3%（14/24），이자비교，차이유통계학의의（U=20.7，P＜0.005）。결론소화도불동부분경조구유기특수초성성상도표현，위산기결국여경조부위이급시부합병기타기형유관；소화도경조태인염색체이상발생솔교고，합병기타결구기형시염색체이상발생솔현저고우단일소화도경조태인。
Objective To explore the ultrasonic feature of congenital digestive tract obstruction prenatal ultrasound, and to retrospectively analyse the perinatal outcome. Methods To collect the complete data of prenatal diagnosis for fetal digestive tract obstruction. Compared with postpartum neonatal special examination and operation results or the corpse and anatomical and pathological examination results after induction, to analyse the prenatal ultrasonographic characteristics. And amniotic fluid or blood chromosome examination results were analyzed. The newborns were followed up for 1 month after birth, tracking the perinatal outcome. Results Totally 87 fetuses (misdiagnosis 2 cases colon atresia with transient dilatation of colon) among 70 278 fetuses(including 1 389 transregional fetuses, 70 278 pregnant women) were considered with digestive tract obstruction, the accidence was 0.1%(85/70 278). 1 case was Missed diagnose with sigmoid colon atresia(postpartum operation confirmed), so the conformity rate was 98.8% (85/86). 21 cases among 86 cases associated with fetal chromosome abnormality, so the rate of which was 24.4% (21/86), including 5 cases esophageal stenosis or atresia, 8 cases duodenal stenosis or atresia, 4 cases intestinal stenosis or atresia, 3 cases colonic stricture or atresia and 1 case anal atresia. 62 cases single digestive tract obstruction associated with chromosome abnormality in 7 cases, so the rate of which was 11.3% (7/62), 24 cases digestive tract obstruction complicated with other malformations associated with chromosome abnormality in 14 cases, so the rate of which was 58.3%(14/24), a comparison of the two, the difference had statistical significance (U=20.7, P<0.005). Conclusion Different parts of digestive tract obstruction has its special ultrasonographic manifestations. Perinatal outcome associated with obstruction position and whether combination of other deformity. Digestive tract obstruction fetal associated with higher chromosomal abnormalities, the rate of digestive tract obstruction fetal combined with other structural malformations associated with chromosomal abnormalities was significant higher than the fetal digestive tract obstruction single.
