摘要
目的探讨产前超声监测胎儿侧脑室扩张的临床意义及预后情况。方法回顾性分析超声检查侧脑室扩张的单活胎112例临床资料,超声动态监测直至分娩或结束妊娠,必要时行病毒学检查及染色体核型分析。记录侧脑室扩张的转归情况,分娩后新生儿情况;胎儿娩出后24~72h复查颅脑B超。出生26~28d以发育商（DQ）评分评价神经系统发育情况,对存活侧脑室扩张者定期随访了解生长发育情况。结果 112例侧脑室扩张胎儿中,轻度扩张85例,中度扩张15例,重度扩张12例;孤立性扩张73例,非孤立性扩张39例。染色体核型分析41例,异常3例（7.32%）;病毒学检查34例,仅1例脐血风疹病毒-IgM阳性。妊娠中晚期超声检查显示,侧脑室扩张完全恢复64例,缩小24例,稳定14例,进展10例;轻度组、中度组、重度组间转归比较,差异有统计学意义（Hc=39.740、9.996,P〈0.05）。112例侧脑室扩张胎儿中,于妊娠中晚期终止妊娠者9例;其余103例均娩出活产新生儿,1例先天性心脏病,1例多发畸形,101例未见明显异常。轻度扩张组与中度扩张组新生儿DQ评分差异无显著性,但均高于重度扩张组（F=15.02、10.76,P〈0.01）。胎儿娩出后复查颅脑B超,有76例新生儿确诊为侧脑室扩张,其中1例多发畸形者于生后第5天死亡。对75例存活侧脑室扩张新生儿随访（3.5±1.3）年,失访5例,2例生长发育迟缓,其余68例未见异常。结论轻中度及孤立性侧脑室扩张胎儿预后较好,重度及非孤立性侧脑室扩张且进行性加重者多预后不良。
Objective To explore the clinical significance of prenatal ultrasonography for fetal lateral ventriculomegaly（LVCM）. Methods Clinical data of 112 cases of single live births with LVCM were reviewed retrospectively.Ultrasound monitoring was carried out until childbirth or termination of pregnancy.Virological examination and chromosome karyotype analysis were conducted when needed.The LVCM and its outcome,and the condition of the neonates were recorded.A cranial ultrasound recheck was done at 24-72 hafter the baby was born.Development quotient（DQ）score was used to evaluate the development of nervous system 26-28 dafter birth.For survivors with LVCM,a regular follow-up was conducted to investigate their growth and development. Results In the 112 fetuses,85 with mild LVCM,15 with moderate LVCM,12 with severe LVCM;isolated LVCM was noted in 73,and non-isolated in 39.Chromosome analysis was done in 41 cases,three（7.32%）were found abnormal;virologic test was done in 34 cases,only one showed IgM-positive rubella virus in umbilical cord blood.Ultrasonography at midtrimester and late pregnancy demonstrated that 64 cases of LVCM were completely recovered,decreased size in 24,stable in 14 and progression in 10;the difference in outcome between mild,midrange,and severe groups was statistically significant（Hc=39.740,9.996;P0.05）.In 112 fetuses with LVCM,nine underwent termination of pregnancy at midtrimester or late stage,the remaining 103 all delivered live births,of whom,one was found with congenital heart disease,and one with multiple abnormalities,the remaining neonates being normal.The difference in DQ score between mild LVCM and midrange LVCM groups was not significant,but all of that were higher than that in severe LVCM group（F=15.02,10.76;P〈0.01）.A re-examination with ultrasound was done in 76 neonates with LVCM,of whom,one with multiple abnormalities died on the fifth day after birth.The 75 infants with the disease were followed up for 3.5±1.3years,five were lost to follow-up,two with growth retardation,the remaining 68 were normal.Conclusion The prognosis of fetuses with mild and moderate or isolated lateral ventriculomegaly is good,and the prognosis of those with severe,non-isolated and aggravated one is poor.
出处
《青岛大学医学院学报》
CAS
2016年第3期328-331,共4页
Acta Academiae Medicinae Qingdao Universitatis
基金
济宁市科技发展计划项目(2013JNWK131)
关键词
侧脑室扩张
超声检查
产前
胎儿疾病
预后
ventriculomegaly
ultrasonography
prenatal
fetal diseases
prognosis
