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内镜逆行胰胆管造影术中胎儿辐射暴露后的长期随访

Long-term follow-up after fetal radiation exposure during endoscopic retrograde cholangiopancreatography.

作者信息

Laudanno Oscar, Garrido Jose, Ahumarán Gabrial, Gollo Pablo, Khoury Marina

机构信息

Instituto de Investigaciones Medicas Doctor Alfredo Lanari - Gastroenterology, Buenos Aires, Argentina.

Hospital C. Boccalandro, Tres de Febrero, Gastroenterology, Buenos Aires, Argentina.

出版信息

Endosc Int Open. 2020 Dec;8(12):E1909-E1914. doi: 10.1055/a-1293-7783. Epub 2020 Nov 27.

DOI:10.1055/a-1293-7783
PMID:33269328
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7695519/
Abstract

The main concern about endoscopic retrograde cholangiopancreatography (ERCP) during pregnancy is the risk of radiation exposure to the fetus. The potential exists not only in the short-term, but also in the long-term and includes growth and development problems and the possibility of childhood cancer. Little is known about the long-term effects of fetal radiation exposure at the time of ERCP. The aim of the study was to report the long-term outcome of babies born after radiation exposure to mothers who underwent ERCP during pregnancy.  This was a single-center retrospective cohort study. We included 24 consecutive pregnant patients who underwent ERCP due to choledocholithiasis and their children, between June 1997 and June 2015. All patients and their babies were followed up until birth to assess their short-term outcome. To assess long-term outcomes, from September 2014 to September 2015, a comprehensive medical interview was conducted with the mothers and their children. We also evaluated medical records, lab tests, school report cards, and the families completed a questionnaire inquiring about perceived health status of the children.  Fifteen patients had full-term pregnancies. One patient had a preterm delivery (32 weeks) due to preeclampsia. There were no cases of miscarriage, stillbirth or fetal malformations. Long-term follow-up was performed at a mean age of 11.08 years (range 1-18) for the children, with no developmental delays, poor school performance, or malignancies found.  Long-term outcome in children born after radiation exposure during ERCP was unremarkable.

摘要

孕期进行内镜逆行胰胆管造影术(ERCP)的主要担忧是胎儿受到辐射暴露的风险。这种风险不仅存在于短期,也存在于长期,包括生长发育问题以及儿童患癌症的可能性。关于ERCP时胎儿辐射暴露的长期影响知之甚少。本研究的目的是报告孕期接受ERCP的母亲辐射暴露后所生孩子的长期结局。

这是一项单中心回顾性队列研究。我们纳入了1997年6月至2015年6月期间因胆总管结石接受ERCP的24例连续妊娠患者及其子女。对所有患者及其婴儿进行随访直至出生,以评估其短期结局。为了评估长期结局,在2014年9月至2015年9月期间,对母亲及其子女进行了全面的医学访谈。我们还评估了病历、实验室检查、学校成绩单,并且家属填写了一份关于儿童感知健康状况的问卷。

15例患者足月妊娠。1例患者因先兆子痫早产(32周)。没有流产、死产或胎儿畸形的病例。对儿童进行长期随访的平均年龄为11.08岁(范围1 - 18岁),未发现发育迟缓、学习成绩差或恶性肿瘤。

ERCP期间辐射暴露后出生的儿童长期结局无异常。

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本文引用的文献

1
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2
Maternal age and the risk of adverse pregnancy outcomes: a retrospective cohort study.母亲年龄与不良妊娠结局风险:一项回顾性队列研究。
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Efficacy and safety of endoscopic retrograde cholangiopancreatography in pregnancy: A high-volume study with long-term follow-up.内镜逆行胰胆管造影术在妊娠期的有效性和安全性:一项长期随访的大样本研究。
Turk J Gastroenterol. 2019 Sep;30(9):811-816. doi: 10.5152/tjg.2019.18799.
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ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis.ASGE 指南:内镜在胆石病评估和管理中的作用。
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Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline.内镜下胆总管结石的处理:欧洲胃肠道内镜学会(ESGE)指南。
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