先天性肺囊腺瘤样畸形40例诊疗分析

目的 分析先天性肺囊腺瘤样畸形胎儿-新生儿的的围产危险因素,探讨其手术时机以及风险管理方法.方法 回顾性分析自2008年10月至2013年1月,来本院就诊40例先天性肺囊腺瘤样畸形病例资料.结合产前诊断以及出生后的胸片、CT检查,分析围产风险因素和手术时机. 结果临床诊断先天性肺囊腺瘤样畸形40例中,顺产17例,剖腹产23例；早产儿3例.出生后有呼吸道症状11例,占27.5％,新生儿期出现呼吸道症状14例,占35.0％.40例中,手术治疗32例；1例放弃治疗,后来死亡；7例家属选择等待.32例手术患儿均治愈出院.平均手术年龄5.6个月.结论 先天性肺囊腺瘤样畸形在新生儿期存在呼吸道风险,应选择在有新生儿外科手术条件的医院生产,出生后需注意预防呼吸道风险,为手术创造条件.

The analysis for treatment of 40 cases congenital cystic adenomatoid malformations

Objetive Analysis of perinatal risk factors for Congenital Cystic Adenomatoid Malformations （CCAM） in fetus and newborns.and To discuss the operation time and the risk management.Methods 40 CCAM cases operated in our institution between 10.2008 to 1.2013 Data on pre-and postnatal investigation：Ⅹ-ray、CT,analysis the operation time and the risk management.Results All the cases,been confirmed by CT scaned postnatal,17 with spontaneous delivery,23 delivered by cesarean section.Respiratory symptom after born with 11 cases,27.5％.Respiratory symptom in neonatal period with 11 cases,35％.In all 40 cases,32 cases under operation with 5.6 months in average age,treatment abandoning in one case,and ＂Wait and See＂ treatment in 7 cases.Conclusion In this review,it showed that the respiratory risk in neonatal period in CCAM.It is necessary to delivery in institution with neonatal surgery condition.It is necessary to pay attention to respiratory risk after birth,and create conditions for the operation.