Muñoz M E, Albert A, Juliá V, Sancho M A, Grande C, Martínez A, Morales L
Servicio de Cirugía Pediátrica, Unidad Integrada Hospital Sant Joan de Déu-Clínic, Universidad de Barcelona, 08950, Barcelona, España.
Cir Pediatr. 2002 Oct;15(4):148-51.
An experimental model of serial amnioinfusion has been developed in fetal rabbits with gastroschisis, using an intraamniotic catheter connected to a subcutaneous port. Fetuses of 4 groups were compared 7 days after surgery: group A: gastroschisis and daily amnioinfusion through an implanted catheter; group C: gastroschisis and blind amniotic catheter; group G: gastroschisis without catheter; group O: nonoperated fetuses. Survival rate, fetal body weight, lung weight, intestinal weight and length were determined. Computer aided morphometric analysis was performed, in which intestinal diameter, thickness and villi length were measured. Amniotic fluid samples were recovered along the experimental period. Intestinal length was significantly shorter and had a significantly thicker wall than nonoperated fetuses; we found no other morphometric differences between gastroschisis treated with amnioinfusion (group A) and the other gastroschisis groups (C and G). Amnioinfusion did not affect fetal survival rate; the amniotic catheter alone did not cause pulmonary hypoplasia due to significant amniotic leak. The physiological decrease in amniotic volume towards the end of gestation has not been modified by this regime of amnioinfusion.
已利用连接皮下端口的羊膜内导管,在患有腹裂的胎兔中建立了连续羊膜腔灌注的实验模型。术后7天比较了4组胎儿:A组:腹裂并通过植入导管每日进行羊膜腔灌注;C组:腹裂并置入盲端羊膜导管;G组:腹裂但无导管;O组:未手术的胎儿。测定了存活率、胎儿体重、肺重量、肠重量和长度。进行了计算机辅助形态计量分析,测量了肠直径、厚度和绒毛长度。在实验期间采集羊水样本。与未手术的胎儿相比,腹裂胎儿的肠长度明显较短,肠壁明显更厚;我们发现,接受羊膜腔灌注治疗的腹裂组(A组)与其他腹裂组(C组和G组)之间在形态计量学上没有其他差异。羊膜腔灌注不影响胎儿存活率;仅羊膜导管不会因明显的羊水渗漏而导致肺发育不全。羊膜腔灌注方案并未改变妊娠末期羊水量的生理性减少。