Wang Ying,Ma Lishuang,Liu Chao,et al.Characteristics of prenatal diagnosis of congenital lung developmental malformation and timing of surgery during neonatal period[J].Journal of Clinical Pediatric Surgery,,22():713-718.[doi:10.3760/cma.j.cn101785-202306042-003]
Characteristics of prenatal diagnosis of congenital lung developmental malformation and timing of surgery during neonatal period
- Keywords:
- Congenital Lung Malformations; Ultrasonography; Prenatal; Genetic Counseling; Prenatal Diagnosis; Surgical Procedures; Operative
- Abstract:
- Objective To explore the characteristics of prenatal diagnosis and neonatal surgery in children with severe congenital lung developmental malformations.Methods There were 10 boys and 2 girls.And they were term (n=9) and premature (n=3) with a minimal gestational age of 32+5 weeks, a mean birth weight of 3135.42 gram and a minimal birth weight of 2200 gram.Prenatal ultrasound examination, pregnancy interventios, postnatal clinical characteristics, surgical approaches and pathological results were recorded.Results All of them obtained a prenatal diagnosis with prenatal consultations.The maximal CVR of dynamic monitoring of prenatal ultrasound was 0.68-5, the mean congenital pulmonary airway malformation-volume (CVR) of the last ultrasound was 1.48, 8 cases of thoracic/abdominal effusion of different degrees and 3 cases of excessive amniotic fluid.Delivery was transferred by transport team through a green channel.There were varying degrees of dyspnea after delivery and 9 cases required respiratory support.The preoperative diagnosis was congenital pulmonary airway malformation (CPAM, n=6), broncho-pulmonary sequestration (BPS, n=4) and congenital lobar emphysema (CLE, n=2).There were neonatal respiratory distress syndrome (n=1), persistent pulmonary hypertension (n=2) and unilateral tension pneumothorax (n=2).Thoracoscopic mini-invasive surgery (n=6) and thoracotomy (n=6) were performed.One case of postoperative pneumothorax was cured by conservative measures.Another case of pectus excavatum was surgically corrected at an age of 3 years while the remainders recovered well.Conclusion High antenatal CVR for congenital lung developmental malformation and early dyspnea after delivery hint at a high possibility of surgery during neonatal period.Closely monitoring vital signs and respiratory status and choosing appropriate surgical timing may yield a decent prognosis.
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Memo
收稿日期:2023-06-27。
基金项目:北京市卫生健康委员会高层次公共卫生技术人才建设项目培养计划（01-034）
通讯作者:马立霜,Email:malishuang2006@126.com