Michejda M
Z Kinderchir. 1985 Dec;40 Suppl 1:53-7. doi: 10.1055/s-2008-1059770.
Fetal therapy has now become a reality and many centres specializing in this field have been established in several countries. The in utero treatment of fetal hydrocephalus is bedevilled by many problems, including poor patient selection, problems with shunt design and general lack of understanding of the pathogenesis of hydrocephalus. Implantation of a ventriculo-amniotic shunt employing a one-way valve into the fetal skull allows continuous evacuation of CSF. One such model has been developed by us and should be ready for clinical trials in the near future. There is strong evidence that the fetal brain has a high capacity for rapid growth and regeneration. However, the process is poorly understood and there is great need for further study. No attempts have yet been made to treat spina bifida in utero. However, the advantages demonstrated in our earlier studies using allogeneic bone transplantation in utero resulted in the development of an allogenic bone paste. This substance can be moulded to any desired shape and is ideal for the restoration of bone loss resulting from cranial injuries or the correction of skull defects. The allogeneic bone paste has been also applied in utero for the repair of surgically induced spina bifida-like lesions in the animal model.
胎儿治疗如今已成为现实，多个国家都设立了许多专注于该领域的中心。胎儿脑积水的宫内治疗面临诸多问题，包括患者选择不当、分流器设计问题以及对脑积水发病机制普遍缺乏了解。将带有单向阀的脑室 - 羊膜分流器植入胎儿颅骨可实现脑脊液的持续引流。我们已经开发出一种这样的模型，并且在不久的将来应该准备好进行临床试验。有强有力的证据表明胎儿大脑具有快速生长和再生的高能力。然而，这个过程还知之甚少，非常需要进一步研究。目前尚未尝试在子宫内治疗脊柱裂。然而，我们早期在子宫内使用同种异体骨移植的研究中所展示的优势促成了一种同种异体骨糊剂的研发。这种物质可以被塑造成任何所需的形状，非常适合修复因颅脑损伤导致的骨质流失或矫正颅骨缺损。同种异体骨糊剂也已在子宫内用于修复动物模型中手术诱导的脊柱裂样病变。
