Mussat P, Dommergues M, Parat S, Mandelbrot L, de Gamarra E, Dumez Y, Moriette G
Service de Médecine Néonatale de Port-Royal, Centre Hospitalier Universitaire Cochin Port-Royal, Paris, France.
Acta Paediatr. 1995 Jul;84(7):749-55. doi: 10.1111/j.1651-2227.1995.tb13749.x.
We consecutively managed 25 cases of fetal chylothorax with hydrops (pleuroamniotic shunting in 20/25 cases). Three of the 16 liveborn infants died before day 5 from malformations (n = 1) or complications of antenatal origin (n = 2). Eleven of the 13 survivors were treated in our unit. Four infants whose chylothorax had resolved before birth following antenatal shunting were delivered at term, and had no respiratory disease. Seven infants, whose chylothorax persisted, were delivered prematurely and required intensive respiratory care (with mechanical ventilation for a median duration of 34 days). The 11 infants were maintained on total parenteral nutrition for a median duration of 31 days. They were discharged home after complete clinical recovery at a median age of 64 days. Antenatal pleuroamniotic shunting may improve the prognosis of congenital chylothorax with hydrops. Chylothorax persisting at birth resolves progressively with medical management.
我们连续处理了25例合并水肿的胎儿乳糜胸病例（25例中有20例行胸腔羊膜腔分流术）。16例活产婴儿中有3例在出生后5天内死亡，原因是畸形（1例）或产前疾病并发症（2例）。13名幸存者中有11名在我们科室接受治疗。4例经产前分流后乳糜胸在出生前已消退的婴儿足月分娩，且无呼吸系统疾病。7例乳糜胸持续存在的婴儿早产，需要重症呼吸支持（机械通气中位时间为34天）。这11例婴儿接受了中位时间为31天的全胃肠外营养支持。他们在临床完全康复后于中位年龄64天时出院回家。产前胸腔羊膜腔分流术可能改善合并水肿的先天性乳糜胸的预后。出生时仍存在的乳糜胸通过内科治疗可逐渐消退。
