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先天性胎儿膈疝(CDH)是胎儿时期膈的发育缺陷导致腹腔内容物疝入胸腔的一种先天畸形,是较严重的先天畸形之一。由于腹腔内容物疝入胸腔压迫肺和心脏,可导致心肺功能不全而致围生儿死亡率增加,围生期死亡率≥75%[1]。影响先天性膈疝(CDH)预后的主要因素是肺发育不良和肺动脉高压,目前各种出生后治疗手段均不能直接、立即改变已经存在的肺发育不良状态,故无法从根本上改善严重CDH的预后。宫内诊断并适时进行干预可能成为CDH有效的一种治疗手段。文章介绍了超声及MRI检查在CDH宫内诊断与肺发育程度评估方面的应用、以胎儿镜下胎儿气管球囊封堵术为重点的宫内干预的应用。
Congenital fetal diaphragmatic hernia (CDH) is a congenital malformation of the abdominal cavity caused by defective development of the diaphragm in the fetal period, which is one of the more serious congenital malformations. Due to intra-abdominal hernia into the chest pressure ophthalmic and cardiac, can lead to cardiopulmonary insufficiency caused perinatal mortality, perinatal mortality ≥ 75% [1]. The main factors that affect the prognosis of congenital diaphragmatic hernia (CDH) are pulmonary dysplasia and pulmonary hypertension. At present, all kinds of post-natal treatment methods can not directly and immediately change the existing state of lung dysplasia, so it can not fundamentally improve the prognosis of severe CDH . Intrauterine diagnosis and timely intervention may be a CDH effective treatment. This article introduces the application of ultrasound and MRI in intrauterine diagnosis of CDH and assessment of lung development, and the application of intrauterine intervention focused on fetus tracheal balloon occlusion.