内镜下气管闭塞术后胎儿肺容积对出生后结局的预测作用
Fetal lung volume after endoscopic tracheal occlusion in the prediction of postnatal outcome.
作者信息
Peralta Cleisson F A, Jani Jacques C, Van Schoubroeck Dominique, Nicolaides Kypros H, Deprest Jan A
机构信息
Department of Obstetrics and Gynecology, Fetal Medicine Units, King's College Hospital, London, United Kingdom.
出版信息
Am J Obstet Gynecol. 2008 Jan;198(1):60.e1-5. doi: 10.1016/j.ajog.2007.05.034. Epub 2007 Sep 12.
OBJECTIVE
The objective of the study was to investigate the volume response of the contralateral lung in the prediction of postnatal outcome in fetuses with congenital diaphragmatic hernia (CDH) treated by fetoscopic endotracheal occlusion (FETO).
STUDY DESIGN
In 30 fetuses with isolated severe CDH that underwent FETO, the volume of the contralateral lung was measured by 3-dimensional ultrasound the day before and 2 and 7 days after FETO. The measurements of fetuses that subsequently died were compared to those who survived.
RESULTS
In all fetuses before FETO, the lung volume was below the 2.5th percentile of the normal range for gestation (60%). Within 2 days after FETO, the lung volume increased to above the 2.5th percentile in 14/21 (66%) that survived, compared with 1/9 (11%) that died. The respective percentages at 7 days after FETO were 95% and 11%, respectively.
CONCLUSION
In fetuses with CDH, the lung responsiveness within 2 and 7 days after FETO provides useful prediction of subsequent survival.
目的
本研究的目的是探讨在胎儿镜下气管阻塞术（FETO）治疗先天性膈疝（CDH）胎儿时，对侧肺的容积反应对出生后结局的预测价值。
研究设计
对30例接受FETO治疗的孤立性重度CDH胎儿，在FETO术前1天、术后2天和7天通过三维超声测量对侧肺容积。将随后死亡的胎儿的测量结果与存活胎儿的测量结果进行比较。
结果
在所有FETO术前的胎儿中，肺容积低于正常妊娠范围的第2.5百分位数（60%）。FETO术后2天内，存活的21例中有14例（66%）肺容积增加到第2.5百分位数以上，而死亡的9例中有1例（11%）。FETO术后7天，相应的百分比分别为95%和11%。
结论
在CDH胎儿中，FETO术后2天和7天内的肺反应性对随后的存活情况有有用的预测价值。
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