胎儿脐-门-体静脉异常分流的产前超声诊断

发布时间：2018-08-07 12:53

【摘要】：目的探讨胎儿脐-门-体静脉异常分流(UPSVS)的产前超声图像特征及其临床预后。方法总结了8例UPSVS的超声图像特征及预后,并行追踪随访。结果 8例UPSVS胎儿中,USS型2例,其中1例脐静脉经冠状静脉窦引流入右心房,生后出现膈疝,经手术治疗,目前6个月健康;另1例下腔静脉肝段缺如,脐静脉肝外异常连接于扩张的奇静脉,引产;DVSS型1例,静脉导管直接与右心房相连,合并小脑蚓部发育不良,引产;3例单纯静脉导管缺失,其中1例足月出生,健康,另2例因合并心内畸形,引产;IHPSS型2例,其中1例门静脉右支与肝右静脉相连,失访,另1例肝左静脉与左门静脉沟通,出生1个月未见异常。结论产前超声检查可诊断UPSVS,影响预后的关键因素为是否合并畸形及是否存在完整的IHPVS,产前精确诊断对预后咨询及产后治疗具有重要价值。
[Abstract]:Objective to investigate the characteristics and clinical prognosis of fetal umbilical portal-body venous shunt (UPSVS) by prenatal ultrasound. Methods the ultrasonographic features and prognosis of 8 cases of UPSVS were summarized and followed up. Results among the 8 cases of UPSVS fetus, 2 cases were of USS type. One case of umbilical vein was introduced into the right atrium through coronary sinus, and the diaphragmatic hernia occurred after birth. After surgical treatment, the patient was healthy for 6 months, and the other case was absent in the hepatic segment of inferior vena cava (IVC). Abnormal connection of extrahepatic umbilical vein to dilated azygous vein was found in 1 case of DVSS type induced labor, direct connection of venous catheter to right atrium, accompanied by hypoplasia of cerebellar vermis, and simple absence of venous catheter in 3 cases of induced labor, of which 1 case was born at term and healthy. There were 2 cases of IHPSS type induced labor due to intracardiac malformation, in which 1 case of right portal vein was connected with right hepatic vein, the other 1 case of left hepatic vein communicating with left portal vein was not abnormal at one month of birth. Conclusion Prenatal ultrasound examination can diagnose UPSVSs. The key factors influencing the prognosis of UPSVSs are the existence of complete IHPVS or not. Prenatal accurate diagnosis is of great value in prognostic counseling and postpartum treatment.
【作者单位】：云南省阜外心血管病医院超声室;昆明医科大学第一附属医院;个旧市妇幼保健院;
【基金】：国家自然科学基金项目(No.81660052)
【分类号】：R445.1;R714.5

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