【摘要】 目的:探讨胎儿宫内输血的临床应用价值。方法:对6例胎儿贫血致胎儿水肿的病例进行经脐静脉宫内输血治疗,输血孕周21+6~30+5周,输血量为15~60 ml,输血1~2次。结果:宫内输血后胎儿贫血症状均得到不同程度改善,MCAPSV值4例降低,1例未改变,1例增高。胎儿腹水及水肿4例消失或减轻,1例无改善,1例继续加重。分娩4例新生儿3例存活,随访其身高、体重及神经行为发育均正常,1例新生儿RDS死亡,2例胎死宫内。结论:宫内输血是一种相对安全的胎儿宫内治疗手段。输血后的胎儿成活率与其本身的疾病状态有关,明确胎儿贫血、水肿原因及掌握宫内输血适应证对改善胎儿预后有直接关系。在胎儿水肿原因不明时仅靠宫内输血改善贫血并不能提高围生儿存活率。更多还原

【Abstract】 Objective: To explore the clinical application value of fetal intrauterine blood transfusion. Methods: Six cases with fetal edema induced by fetal anemia were treated with transumbilical intrauterine blood transfusion during 21+ 6- 30+ 5gestational weeks,the amount of blood transfusion was 15- 60 ml,blood transfusion was performed for 1- 2 times. Results: After intrauterine blood transfusion,fetal anemic symptoms were improved in varying degrees,MCA- PSV value decreased in four cases and increased in one case,while in the other one case,MCA- PSV value did not change. Fetal ascites and edema disappeared or relieved in four cases and aggravated in one case,while in the other one case,fetal ascites and edema did not change. Four cases delivered successfully,and three neonates survived; body height,body weight and neurobehavioral development were normal during follow- up; one neonate died of RDS,two intrauterine deaths occurred. Conclusion: Intrauterine blood transfusion is a relatively safe treatment. Fetal survival rate after blood transfusion is related to their disease states. Understanding the reasons of fetal anemia and edema and mastering therapeutic indications strictly can improve the prognosis of fetuses. Simple intrauterine blood transfusion can not improve anemia and increase perinatal survival rate when the reasons of fetal edema are unexplained.更多还原