胎儿颈部肿块的分娩期子宫外产时治疗(附1例报道)

目的探讨小儿外科畸形早期外科干预的一种新途径,即分娩时子宫外产时治疗的可行性。方法通过文献复习及对近期开展的1例产前超声诊断胎儿颈部肿块成功进行分娩期子宫外产时治疗。结果在维持母-儿循环时给患儿进行气管插管,建立机械通气,出生后8d切除颈部肿瘤,手术获得成功。结论及时产前诊断胎儿气道梗阻,通过分娩时子宫外产时治疗,在维持母-胎循环时使患儿获得气道通畅,改善了围产结局。

The feasibility of the ex-utero intrapartum treatment

Objective To study a novel approach to treat fetal with a congenital defect of prenatal diagnosis when delivery,and discuss the feasibility of the ex-utero intrapartum treatment(EXIT).Methods We reviewed literature and present a case in which prenatally a fetal neck mass was diagnosed on ultrasound,and a successful EXIT procedure was be performed.Results We intubated the fetus orotracheally by direct laryngoscopy while fetal-maternal circulation was preserved.Fetal obtained airway.Postnatally,the infant underwent surgery 8 days after birth and the surgery was doing well.Conclusions Timely antenatal diagnosis is indispensable in reducing morbidity and mortality caused by upper airway obstruction.The early defect repair may terminate the development of pathophysiological status.The EXIT procedure can be used to obtain a fetal airway while feto-maternal circulation is preserved to optimise fetal outcome.