摘要
目的对我院进行产时手术的出生缺陷儿的预后进行随访,评价产时手术的可行性与优越性。方法选择2008年8月至2010年7月在我院进行产时手术治疗的患者16例(包括淋巴管瘤3例,先天性膈疝2例,骶尾部畸胎瘤2例,脐膨出7例,腹壁裂2例),其中产时胎儿手术(IHS)4例,子宫外产时处理(EXIT)同时行产房外科手术(IFO)12例,在生后的1个月至2年对患儿从体格发育(体质量、身长)、智力发育、认知发育及社会适应能力(DDST)方面进行评估。结果 16例患儿存活14例,死亡2例,生存率87.50%。存活14例均在术后定期随访,随访时间为1个月至2年,其中12例生长发育正常,占85.71%。1例膈疝患儿因术后并发症多,预后不理想,这可能与疾病本身的性质有关。另1例巨型脐膨出患儿生长发育欠佳,可能与其早产及先天性梅毒有关。结论产时手术是可行的,并有其独特的优越性,能改善婴幼儿预后,不影响婴幼儿预后。
Objective To follow up the prognosis of intrapartum sugery for birth-defect and to evaluate its the feasibility and superiority of intrapartum fetal sugery.Methods 16 cases（including 3 cases of lymphangioma,2 cases of congenital diaphragmatic hernia,2 cases of sacrococcygeal teratoma,7 cases of omphalocele,2 cases of gastroschisis）were choosed from August 2008 to July 2010 in our hospital for intrapartum surgery,in which 4 cases for intrapartum fetal surgery,12 cases for exutero intrapartum treatment（EXIT） in house surgery.For 1 month to 2 years after birth,assessments of physical development（weight,height）,mental development,cognitive development and social adaptation（DDST）were conducted on children.Results 14 of the 16 patients were alive,2 died.The survival rate was 87.50%.The 14 survivals were regularly followed up for 1 month to 2 years.12 of them（85.71%）have normal growth and development so far.The prognosis of one case of diaphragmatic hernia is not satisfactory because of the postoperative complications,which may be related to the nature of the disease itself.Another case of giant omphalocele with poor growth and development may be related to premature birth and congenital syphilis.Conclusion The intrapartum sugery is feasible with its unique advantages,and can improve the prognosis of infants.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2011年第4期327-330,共4页
Journal of China Medical University
基金
辽宁省科学技术计划(2010225034)
关键词
产时手术
出生缺陷
随访
预后
intrapartum sugery
birth-defect
follow up
prognosis
