摘要
目的探讨单纯性轻度侧脑室扩张胎儿的官内转归及预后。方法前瞻性选择2006年1月至2009年12月于温州医学院附属第二医院行常规产前检查的单胎孕妇共18200例，自妊娠第20周开始，由专职B超医师仔细测量胎儿侧脑室后角宽度，将胎儿单纯性轻度侧脑室扩张（即侧脑室增宽10～15mm，不合并胎儿结构畸形）者纳入本研究，共148例。根据首次检查侧脑室扩张的程度，将单纯性轻度侧脑室扩张分为2组：A组：侧脑室宽度为10—11mm，99例，B组：侧脑室宽度为12～15mm，49例，每2～4周动态观察胎儿侧脑室宽度的变化及其他异常情况，并对新生儿出生后神经行为发育情况进行随访。结果（1）发生率：胎儿单纯性轻度侧脑室扩张发生率为0．08％（148／18200），其中双侧脑室扩张45例，A组双侧脑室扩张发生率为20％（20／99），B组为51％（25／49），两组比较，差异有统计学意义（P〈0．05）；（2）宫内转归：148例中139例至少进行过2次或2次以上的超声随访，单纯性轻度侧脑室扩张宫内消失占41．7％（58／139），缩小占7．9％（11／139），稳定占36．7％（51／139），进展占13．7％（19／139）；A组进展者5例，B组进展者14例，两组比较，差异有统计学意义（P〈0．05）；（3）新生儿神经行为发育情况：111例新生儿出生后随访5～12个月，神经行为发育异常率为5．4％（6／111）；进展者新生儿出生后神经行为发育异常率（3／15）明显高于消失者（2．5％，1／40）、减少者（0，0／8）和稳定者（4．2％，2／48），分别比较，差异均有统计学意义（P〈0．05）。结论85％以上的胎儿单纯性轻度侧脑室扩张在宫内消失、缩小或稳定，预后良好；脑室扩张≥12mm，且宫内有进展者提示预后不良，应引起高度重视。
Objective To investigate outcome and prognosis of isolated mild fetal ventficulomegaly （IMV） of fetus in uterus. Methods From Jan. 2006 to Dec. 2009, 18 200 singleton pregnancy women from 20 weeks gestation underwent prenatal ultrasonography examination in Department of Obstetrics and Gynecology, Second Affiliated Hospital of Wenzhou Medical College. One hundred and forty-eight women with IMV （transverse diameter of the atrium of the lateral ventricle measuring between 10 and 15 mm with no other abnormalities） were studied prospectively, which were divided into two groups： 99 women with transverse diameter of the lateral ventricle of 10 - 11 mm in group A and 49 women with transverse diameter lateral ventricle of 12 - 15 mm in group B. The changes of ventriculomegaly and the associated intracranial and extracranial anomalies were observed regularly every 2 or 4 weeks until delivery. The development of neurological system was also followed up. Results （1） The overall incidence of IMV was 0. 08% （148/18 200）. The rate of bilateral ventriculomegaly were 20% （20/99）in group A and 51% （25/49）in group B, which reached statistical difference （P 〈 0. 05）. （2） Prognosis of fetus： 139 cases with 2 or more ultrasonographic examinations, IMV resolved throughout pregnancy in 41.7% （58/139） ,regressed in 7. 9% （ 11/139 ）, remained stable in 36. 7 % （ 51 / 139 ） and progressed in 13.7 % （ 19/139 ）. Five cases in group A and 11 cases in group B present progress, which reached significantly difference （ P 〈 0. 05 ）. （ 3 ） One hundred and eleven cases infant were followed up for 5 -12 months, the rate of psycho-motor developmental delay was 5.4% （6/111 ）. The rate of neuro-developmental delay in progressed group （3/15） was higher than 2. 5% （1/40） in resolved group, 0 （0/8） in regressed group and 4. 2% （2/48） in remained stable group, which ,＇cached significantly difference （P 〈 0. 05 ）. Conclusions About 85% of cases of IMV resolved, regressed or renmined stable in utero would exhibited good prognosis. IMV with a transverse atrial size≥12 mm or progression in utero was usually associated with a poor prognosis, which should be observed carefully.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2011年第6期418-421,共4页
Chinese Journal of Obstetrics and Gynecology
基金
浙江省医药卫生科技计划（20098109）
关键词
脑室
先天畸形
超声检查
产前
神经行为发育
预后
Cerebral ventricles
Congenital abnormalities
Ultrasonography, prenatal
Neurobehavioral development
Prognosis
