【摘要】：目的探討胎兒臍-門-體靜脈異常分流(UPSVS)的產(chǎn)前超聲圖像特征及其臨床預(yù)后。方法總結(jié)了8例UPSVS的超聲圖像特征及預(yù)后,并行追蹤隨訪。結(jié)果 8例UPSVS胎兒中,USS型2例,其中1例臍靜脈經(jīng)冠狀靜脈竇引流入右心房,生后出現(xiàn)膈疝,經(jīng)手術(shù)治療,目前6個月健康;另1例下腔靜脈肝段缺如,臍靜脈肝外異常連接于擴(kuò)張的奇靜脈,引產(chǎn);DVSS型1例,靜脈導(dǎo)管直接與右心房相連,合并小腦蚓部發(fā)育不良,引產(chǎn);3例單純靜脈導(dǎo)管缺失,其中1例足月出生,健康,另2例因合并心內(nèi)畸形,引產(chǎn);IHPSS型2例,其中1例門靜脈右支與肝右靜脈相連,失訪,另1例肝左靜脈與左門靜脈溝通,出生1個月未見異常。結(jié)論產(chǎn)前超聲檢查可診斷UPSVS,影響預(yù)后的關(guān)鍵因素為是否合并畸形及是否存在完整的IHPVS,產(chǎn)前精確診斷對預(yù)后咨詢及產(chǎn)后治療具有重要價值。
[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.
【作者單位】： 云南省阜外心血管病醫(yī)院超聲室;昆明醫(yī)科大學(xué)第一附屬醫(yī)院;個舊市婦幼保健院;
【基金】：國家自然科學(xué)基金項(xiàng)目(No.81660052)
【分類號】：R445.1;R714.5

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