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[胎儿水肿合并胸腔积液/乳糜胸的产前诊断与治疗]

[Prenatal diagnosis and therapy of hydro-/chylothorax with fetal hydrops].

作者信息

Rempen A, Dame W, Jorch G, Pfefferkorn J

出版信息

Z Geburtshilfe Perinatol. 1984 Mar-Apr;188(2):90-3.

PMID:6375182
Abstract

The prenatal diagnosis of a massive bilateral hydro-/chylothorax at 34 weeks of gestation is presented. It was associated with a marked hydrops which probably had resulted from protein depletion into the pleural cavity and/or elevation of intrathoracic pressure with subsequent obstruction of venous return. So the hydro-/chylothorax is to be considered a further cause of the congenital hydrops universalis. After induction of lung maturation with dexamethasone the infant was delivered by a primary cesarean section at 36 weeks of pregnancy. The immediately following intensive care guaranteed the circulatory function and ventilation. The pleural effusions were managed successfully by careful continuous intrapleural drainage and intravenous protein substitution. Last not least, the survival of the infant despite the massive findings is to be owed to the close cooperation of pediatricians and obstetricians.

摘要

本文介绍了一例妊娠34周时产前诊断出的双侧大量胸腔积水/乳糜胸病例。它与明显的水肿有关,这可能是由于蛋白质进入胸腔导致消耗以及/或者胸腔内压力升高随后阻碍静脉回流所致。因此,胸腔积水/乳糜胸应被视为先天性全身性水肿的另一个原因。用地塞米松诱导肺成熟后,婴儿在妊娠36周时通过初次剖宫产分娩。随后立即进行的重症监护确保了循环功能和通气。通过仔细持续的胸腔内引流和静脉内蛋白质替代成功处理了胸腔积液。最后但同样重要的是,尽管有大量异常表现,婴儿仍存活应归功于儿科医生和产科医生的密切合作。

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