合并胎儿水肿的肺叶外型肺隔离症患儿的静脉动脉化

作     者：Kitano Y. Matsuoka K. Honna T. 贺莉 

作者机构：Division of General SurgeryNational Center for Child Health and DevelopmentSetagaya-kuTokyo 157-8535Japan 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2006年第2卷第8期

页      面：48-49页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：肺叶外型肺隔离症 静脉动脉化 胎儿水肿 患儿 胸膜腔积液 胸腔穿刺术 先天性膈疝 EPS 静脉阻塞 胸腔积液 

摘      要：Background/Purpose:Fetal extralobar pulmonary sequestration(EPS)is sometime s complicated by massive pleural effusion(PE)leading to fetal *** und erlying mechanisms as well as the origin of the fluid are not well understood.T his study was performed to find a histological hallmark of an EPS with massive P *** hypothesized that venous obstruction has a role to play in the mechanisms of fluid production by ***:We recently experienced 3 cases of fetal EP S complicated by fetal hydrothoraxrequiring thoracentesis and eventually thoraco amniotic shunt *** protein content and cell count were measured in the aspirates,which were compared with chylothorax cases(n = 5)requiring feta l shunt *** birth,all 3 infants required mass resection for the co ntrol of *** venous wall thickness was measured on pathology slides stained with Elastica van Gieson *** of the media and adventitia was mea sured in approximately 40 veins per *** were corrected by external diamet er and expressed as percentage of medial thickness and percentage of adventitial *** EPS not associated with PE but with congenital diaphragmatic hern ia served as a ***:Total protein and the cell count of the EPS rel ated PE were 0.6 ±0.3 mg/dL and 28 ±14/μL(mean ±SD),which were significantly lower than those of PE i n chylothorax(2.2 ±0.2 mg/dL and 1900 ±1100/μL).Percentages of adventitial thickness of EPS with PE were 9.8%±3.8%,10.4%±3.6%,and 8.3%±3.7%,whi ch were significantly increased compared with the control of 3.1%±1.3%(P 0.01).Percentages of medial thickness of EPS with PE were 7.0%±1.9%,7.3%±1.4%,and 6.6%±2.3%,which were significantly increased compared with the cont rol of 2.3%±0.7%(P 0.01).Conclusions:We conclude that PE associated with EPS is the transudate rather than the *** thickened media and the adventi tia found in EPS with PE support the hypothesis that partial obstruction of the venous system leads to an i