【摘要】 目的:探讨胎粪性腹膜炎（MP）的围产期特征及其远期预后。方法:回顾性分析2010年1月至2018年12月在四川大学华西第二医院和成都市妇女儿童中心医院诊断的13例MP的临床资料。结果:13例产妇中位年龄为28岁,13例MP均为产前超声确诊,确诊孕周22～37⁺²周,中位孕周30⁺³周。产前超声检查最常见的声像表现为肠管扩张8例（61.5%）,羊水过多5例（38.5%）,腹水5例（38.5%）,钙化病灶2例（15.4%）,肠道强回声2例（15.4%）。13例MP出生中位胎龄37⁺⁴周,中位体质量3220 g; 8例（61.5%）为顺产,5例（38.5）为剖宫产;其中6例（46.2%）为早产儿;13例患儿唐氏筛查均呈阴性。12例患儿Apgar评分达正常,1例患儿重度窒息,后转入新生儿科后行气管插管。11例MP患儿接受手术治疗,其余2例保守治疗,最终12例存活。通过随访观察,患儿身高、体质量均在正常范围内且发育正常。结论:超声对MP的产前诊断和预后预测有重要意义。MP患儿预后良好,无严重的生长发育不良,但应在孕中晚期时进行动态监测并积极做好产前准备,同时在生长发育过程中应当更注重患儿的营养状况。更多还原

【Abstract】 Objective:To analyze the perinatal characteristics of meconium peritonitis（MP） and draw a preliminary conclusion in long-term outcomes.Methods:13 cases of MP from January 2010 to December 2018 in West China Second University Hospital and Chengdu Women′s and Children′s Central Hospital were analyzed retrospectively.Results:The median age of 13 MP was 28 years old.All 13 cases were diagnosed by prenatal ultrasound.The diagnosed gestational age was 22～37⁺² weeks, and the median gestational age was 30⁺³ weeks.The most common ultrasound manifestations were intestinal dilatation in 8 cases（61.5%）,polyhydramnios in 5 cases（38.5%）,ascites in 5 cases（38.5%）,calcified lesions in 2 cases（15.4%）,and strong intestinal echo in 2 cases（15.4%）.13 cases of MP were born with a median gestational age of 37⁺⁴weeks and a median body weight of 3220 g, 8 cases（61.5%） had normal delivery, 5 cases（38.5%） had cesarean section, 6 cases（46.2%） were premature infants.Down′s screening of 13 children was negative.The Apgar score of 12 was normal, and 1 case was severely asphyxiated and had tracheal intubation.11 children with MP received surgical treatment, and the remaining two were treated conservatively.Finally, 12 survived.Through follow-up observation of 13 children, the height and weight were within the normal range and the development was normal.Conclusions:Ultrasound has a significance in diagnosis and prediction of the prognosis of MP.Surgery is the major treatment of MP and results in better survival rates.Patients of MP can have favorable prognosis and the termination should be selected reasonably.At the same time, more attention should be paid to the nutritional status of children with MP during the growth and development.更多还原