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目的:了解先天性肺囊性腺瘤样畸形(CCAM)患儿的发病情况、治疗过程、妊娠结局、产后随访,探讨影响妊娠结局的相关因素。方法:选取2007~2012年佛山市5个区分娩率较高的6家医院监测对象住院妊娠结局为流产(引产)或分娩的孕满9周至出生的死胎、活产儿中产前超声诊断为CCAM的患儿,运用卡方趋势检验分析CCAM患儿发病率及妊娠结局的变化趋势,运用多元Logistic回归分析CCAM患儿妊娠结局相关影响因素。结果:在152 166例孕妇中,产前超声诊断为CCAM共51例,发病率为3.34/万。2007~2009年CCAM患儿的妊娠结局以引产为主,2010~2012年以活产分娩为主,足月活产分娩CCAM患儿的并发症中肺炎发生率高于无特殊原因足月活产分娩的新生儿(P<0.05)。在孕期或分娩期对患儿采取外科干预可以取得良好的治疗效果,随访示患儿情况良好。孕产妇的居住地、不良生育史及胎儿是否合并胸腹水等特殊情况是妊娠结局的影响因素。结论:先天性肺囊性腺瘤样畸形增加新生儿肺炎发生率,2007~2009年CCAM患儿的妊娠结局以引产为主,2010~2012年以活产分娩为主。孕产妇居住地在城市、有不良生育史及CCAM患儿病情轻是CCAM患儿活产分娩的保护因素。
Objective: To investigate the incidence of congenital cystic adenomatoid malformation (CCAM) in children, the course of treatment, pregnancy outcome, postpartum follow-up, to explore the impact of pregnancy-related factors. Methods: Six hospitals with high delivery rates in five districts of Foshan from 2007 to 2012 were enrolled in this study. The hospitalized pregnancy outcomes were miscarriage (induced labor) or stillbirth during delivery until 9 weeks after birth. Prenatal ultrasound was diagnosed as CCAM Of children, the use of chi-square trend test analysis of children with CCAM incidence and pregnancy trends trends, multivariate logistic regression analysis of CCAM children with pregnancy-related factors. Results: Among 152 166 pregnant women, 51 cases were diagnosed with prenatal ultrasound as CCAM with a morbidity of 3.34 per 10,000. From 2007 to 2009, the outcome of pregnancy in CCAM children was mainly induced labor. From 2010 to 2012, the incidence of pneumonia was higher in CCAM children with full-term live birth than in full-term live birth without special causes Newborns with childbirth (P <0.05). Surgery during childbirth or during childbirth to take surgical intervention can achieve good results, follow-up showed that children in good condition. Pregnancy maternal place of residence, poor birth history and the fetus is associated with pleural, ascites and other special circumstances is the impact of pregnancy outcome. CONCLUSIONS: Congenital cystic adenomatoid deformity increases the incidence of neonatal pneumonia. The outcome of pregnancy in CCAM children from 2007 to 2009 was mainly induced labor. From 2010 to 2012, labor-based delivery was the mainstay. Maternal living in the city, with a history of poor birth and CCAM children with mild disease is CCAM children live birth protection.