Bengtsson Bengt-Ola S
Pediatrix Medical Group of California, Neonatal Intensive Care Unit, Community Memorial Hospital of San Buenaventura, Ventura, California.
Am J Perinatol. 2014 Dec;31(12):1037-42. doi: 10.1055/s-0034-1370349. Epub 2014 Feb 24.
The aim of the study was to describe our cases of neonatal chylous effusions and their outcomes and attempt to identify prognostic factors that can aid in the counseling of parents of future patients.
A retrospective chart review was conducted on all patients with a diagnosis of chylous effusions admitted to our 16-bed community level-3 neonatal intensive care unit (NICU) between June 2003 and November 2013.
A total of 10 patients were identified: of these 10 patients, 3 survived and 6 expired. One patient was transferred out and was lost to follow-up. Two-thirds of the survivors had only one site of chylous effusion. The six mortalities were all of gestational age (GA) < 34 weeks; five of the six were low birth weight (LBW) and all six had anasarca/hydrops, two or more sites of chylous effusions, or a genetic syndrome/chromosomal abnormality. The incidence of chylous effusions was 0.03% of all births and these patients constituted 0.37% of the inborn admissions to the NICU.
This case series represents a large number of patients considering its single-center community setting. It is prudent to communicate a very guarded prognosis when counseling parents of neonates with chylous effusions. Multiple chylous effusions, hydrops, GA < 34 weeks, LBW, or an accompanying genetic syndrome appear to confer worse prognosis.
本研究旨在描述我们的新生儿乳糜性积液病例及其结局，并试图确定有助于为未来患者家长提供咨询的预后因素。
对2003年6月至2013年11月期间入住我们拥有16张床位的社区三级新生儿重症监护病房（NICU）且诊断为乳糜性积液的所有患者进行回顾性病历审查。
共确定10例患者：这10例患者中，3例存活，6例死亡。1例患者转出后失访。三分之二的存活者仅有一个乳糜性积液部位。6例死亡患者的胎龄（GA）均<34周；6例中有5例为低出生体重（LBW），且6例均有全身水肿/积水、两个或更多乳糜性积液部位或遗传综合征/染色体异常。乳糜性积液的发生率占所有出生婴儿的0.03%，这些患者占NICU内出生入院患者的0.37%。
考虑到其单中心社区环境，本病例系列涵盖了大量患者。在为患有乳糜性积液的新生儿家长提供咨询时，谨慎传达非常保守的预后是明智的。多处乳糜性积液、积水、GA<34周、LBW或伴有遗传综合征似乎预示着更差的预后。
