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世界核心医学期刊文摘（儿科学分册） 2005年第9期1卷 29-30页

作者： Cortes R.A. Keller R.L. Townsend T. K.K. Nobuhara 朱新菊 Dept. Surg. and Fetal Treatm. Ctr. Univ. California S. Francisco M. San Francisco CA 94143-0570 United States

Fetal tracheal occlusion (TO) was developed in an attempt to enhance prenatal lung growth and improve survival in fetuses with severe congenital diaphragmatic hernia (CDH). We conducted a randomized, controlled clinical trial in 24 fetuses with severe left CDH (liver herniated into the thorax and low lungto-head ratio) to compare survival after endoscopic fetal TO vs standard perinatal care (control) and prospectively followed up the 16 survivors (9 control, 7 TO) to compare neurodevelopmental, respiratory, surgical, growth, and nutritional outcomes. At 1 and 2 years old, subjects underwent evaluation consisting of medical and neurological history and physical, developmental testing, nutritional assessment, oxygen saturation and pulmonary function testing, chest radiograph, and echocardiogram. Growth and developmental measures were corrected for prematurity. Data were analyzed by Mann-Whitney rank sum test, Fisher’ s exact test, and logistic and linear regression. Infants with TO were significantly more premature at birth (control vs TO, 37.4 ± 1.0 vs 31.1 ± 1.7 weeks; P < .01). Growth failure (z score for weight < 2 SDs below mean) was severe in both groups at 1 year of age (control vs TO, 56% vs 86% ; P = .31). There was considerable catch-up growth by age 2 years (growth failure: control vs TO, 22% vs 33% ; P =.19). There were no differences in other growth parameters. There were also no differences in neurodevelopmental outcome at 1 and 2 years. Supplemental oxygen at hospital discharge was a significant predictor of worse neurodevelopmental outcome at 1 and 2 years old (P =.05 and P =.02, respectively). Hearing loss requiring amplification has been diagnosed in 44% of the group (control vs TO, 44% vs 43% ; P = 1.0). In this group of infants with severe CDH, there were no differences in outcome at 2 years old despite significant prematurity in the TO group. Oxygen supplementation at hospital discharge identified the most vulnerable group with respect to neurodev

关键词：横膈膜疝存活者神经系统发育先天性膈疝超声心动图放射学检查发育不足内窥镜检查诊断营养评估发育状况

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胸腔内胃体疝的产前诊断

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世界核心医学期刊文摘（儿科学分册） 2005年第7期1卷 45-45页

作者： Al-Assiri A. Wiseman N. Bunge M. 肖莉 Pediat.Surg.and Radiol.Depts. Children's Hospital University of Manitoba Winnipeg Man.R2N 3W9 Canada

Intrathoracic stomach is a rare and serious congenital *** anomaly may be complicated by gastric volvulus and can lead to ischemic gastric infarction in the *** diagnosed antenatally, neonatal management can be planned in advance so as to reduce *** anomaly must be differentiated from the more common congenital diaphragmatic hernia, as associated pulmonary hypoplasia is common in the latter and rare with gastric *** report an infant born to a mother with Marfan’s syndrome with the antenatal diagnosis of intrathoracic *** ultrasound and magnetic resonance imaging features of this congenital abnormality are described.A review of the literature would indicate that this is the first case report of gastric volvulus diagnosed in utero.

关键词：产前诊断宫内诊断先天性异常出生前横膈膜疝马凡综合征胃扭转磁共振图像发育不良婴儿期

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