与无囊肿相比，脊髓脊膜膨出囊肿是否会导致开放性脊柱裂母体胎儿手术后出生后腿部功能下降？
Does a myelomeningocele sac compared to no sac result in decreased postnatal leg function following maternal fetal surgery for spina bifida aperta?
作者信息
Wilson R Douglas, Johnson Mark P, Bebbington Michael, Flake Alan W, Hedrick Holly L, Sutton Leslie N, Adzick N Scott
机构信息
Department of Surgery and Obstetrics and Gynecology, Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-4399, USA.
出版信息
Fetal Diagn Ther. 2007;22(5):348-51. doi: 10.1159/000103294. Epub 2007 Jun 5.
OBJECTIVE
A fetus with large sac S1 myelomeningocele (MMC) but bilateral talipes prompted the question, 'Does the presence or size of an MMC sac affect postnatal leg function?'
STUDY DESIGN
An MMC database with prenatal, birth, and a minimum of 1-year follow-up evaluation was reviewed. All fetuses had in-utero MMC repair at 20 + 0 to 25 + 6 weeks at a single institution. Fifty-four fetuses had prenatal evaluation, with 48 children completing a birth and a 1-year evaluation of leg function.
RESULTS
An MMC sac was present in 38/54 (70%) of fetuses evaluated in-utero and had been present in 35/48 (73%) of children evaluated at 1 year of age. Although leg function evaluated at 1 year was better than expected in the 'no sac' group (p = 0.059), this did not reach statistical significance.
CONCLUSION
The presence of an MMC sac may increase postnatal lower limb morbidity.
目的
一名患有巨大骶1型脊髓脊膜膨出（MMC）但双侧足畸形的胎儿引发了这样一个问题：“MMC囊的存在或大小会影响出生后腿部功能吗？”
研究设计
回顾了一个包含产前、出生及至少1年随访评估的MMC数据库。所有胎儿均在单一机构于孕20 + 0至25 + 6周接受了宫内MMC修复手术。54例胎儿接受了产前评估，其中48名儿童完成了出生时及1岁时的腿部功能评估。
结果
在宫内接受评估的54例胎儿中，38例（70%）存在MMC囊，在1岁时接受评估的48名儿童中，35例（73%）存在MMC囊。尽管在“无囊”组中，1岁时评估的腿部功能比预期要好（p = 0.059），但未达到统计学意义。
结论
MMC囊的存在可能会增加出生后下肢发病风险。
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