文章摘要
段仰灿,孟艳红,王聪,张忠路,任淑君.Ⅰ型及Ⅲ型食管闭锁的产前超声表现及病理分析[J].济宁医学院学报,2021,44(3):193-196
Ⅰ型及Ⅲ型食管闭锁的产前超声表现及病理分析
Analysis on prenatal ultrasonographic geatures of type Ⅰ and type Ⅲ esophageal atresia and pathological basis
投稿时间:2021-03-09  
DOI:10.3969/j.issn.1000-9760.2021.03.010
中文关键词: 超声表现;食管闭锁;病理改变
英文关键词: Ultrasound;Esophageal Atresia;Pathology
基金项目:山东省中医药科技发展计划(2019-0478);济宁市重点研发计划(2019SMN004)
作者单位E-mail
段仰灿 济宁医学院附属医院, 济宁 272029  
孟艳红 济宁医学院附属医院, 济宁 272029  
王聪 济宁医学院附属医院, 济宁 272029  
张忠路 济宁医学院附属医院, 济宁 272029 15853733198@163.com 
任淑君 济宁医学院附属医院, 济宁 272029  
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中文摘要:
      目的 探究Ⅰ型及Ⅲ型食管闭锁(esophageal atresia,EA)胎儿的产前超声表现及其病理变化。方法 回顾性分析30例经尸检、手术或造影确诊的Ⅰ型及Ⅲ型EA患儿产前超声表现,并分析闭锁上、下段食管盲端及瘘口周围食管和气管的情况及病理改变。结果 产后确诊的Ⅰ型及Ⅲ型EA胎儿30例,Gross Ⅲ型EA 23例,Gross Ⅰ型7例;30例胎儿产前超声发现上段食管软组织增厚30例(100.0%),上段食管囊袋状扩张18例(60.0%),气管、支气管管径扩张7例(23.3%),羊水过多合并无或小胃泡13例(43.3%);15例(50.0%)胎儿可于产前评估闭锁段距离。HE染色结果表明闭锁上段食管盲端的肌层细胞轻度增生肥大,扩张的气管壁内软骨及肌肉成分减少,Ⅲ型EA下段食管组织内可见软骨成分;I型EA下段食管管壁结构不全。结论 I型及Ⅲ型胎儿EA具有典型的超声表现,其主要的病理特点是食管及气管结构组织发育异常。
英文摘要:
      Objective To explore prenatal ultrasonographic features of Type Ⅰ and Type Ⅲ esophageal atresia (EA) and pathological changes.Methods A retrospective analysis on prenatal ultrasonographic features of 30 cases of congenital esophageal atresia diagnosed by autopsy,surgery or angiography was made,to find the pathology changes of the upper and lower blind end of esophagus atresia,the esophagus and trachea surrounding the fistula.Results In 30 cases of Type Ⅰ and Type Ⅲ esophageal atresia fetuses diagnosed after delivery,23 cases of Gross III esophageal atresia,7 cases of Gross I;30 cases of soft tissue thickness of upper esophagus(100.0%),18 cases of capsular dilatation of upper esophagus(60.0%),7 cases of abnormal diameter of trachea or bronchus(23.3%),and of polyhydramnios with no or small stomach were found with ultrasound(43.3%);15 cases of the length of atresic part can be estimated before delivery.Mild hyperplasia of Cells in muscular layer of the upper blind end of atresia esophagus occurred,composition of cartilage and muscle in dilated trachea reduced,and cartilage can be found in the lower esophagus tissues of Type Ⅲ esophageal atresia;The lower esophageal wall of Type Ⅲ esophageal atresia is incomplete in structure.Conclusion Soft tissue thickness of upper esophagus is the typical ultrasonographic feature of Type Ⅰ and Type Ⅲ congenital esophageal atresia.The main pathological change is developmental anomalies of esophagus and trachea cells.
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