438例胎儿和围产儿尸检中先天畸形的临床病理分析.docVIP

438例胎儿和围产儿尸检中先天畸形的临床病理分析 徐承平，葛晓冬，李晓林，卞修武（400038重庆，第三军医大学西南医院病理学研究所） [摘要]目的 通过病理解剖检查，探讨胎儿和围产儿先天畸形的发生情况及临床病理特点。方法 回顾性分析我院2005年1月至2010年12月438例产科和儿科的围产儿及胎儿尸检资料和临床资料，并对先天性畸形及主要死因进行分析。结果 临床诊断与病理解剖诊断符合率为92%。438例围产儿及胎儿尸检中畸形检出率达85.84%（376/438例），最常见为神经系统17.35%（76/376）和循环系统16.44%（72/376），其次为头面五官（42/376）、运动骨骼（32/376）、泌尿生殖（30/376）、呼吸（30/376）、染色体病（26/376）、消化（20/376）等系统畸形。其中单一畸形64.63%（243/376），多发畸形35.37%（133/376）。结论 先天畸形是影响围产儿及胎儿死亡的重要因素。病理解剖检查是提高胎儿畸形检出率及明确死因的有效手段。 [关键词] 围产儿；胎儿；尸检；先天性畸形 [中图法分类号] R722 [文献标志码] A The clinical pathologic analysis of the congenital malformations in 438 cases of fetal and perinatal autopsy Xu Chengping，Ge Xiaodong，Li Xiaolin，Bian Xiuwu （Institute of Pathology，SouthwestHospital，Third Military Medical University，Chongqing 400038，China） [Abstract] Objective To investigate the incidence and clinical pathologic characteristics of congenital malformation in fetal and perinatal through pathological examination.Methods We have collected 438 autoptical specimens from January 2005 to December 2010. Using the way of autopsy and pathologic organization slices，congenital malformation and main causes of death of neonatal had been analyzed. Results The coincidencerate of clinical diagnosis and pathological anatomy diagnosis was 92%.The incidence of congenital malformation in 438 cases of fetal and perinatal autopsy was 85.84%（376/438）. The mean incidence of congenital malformations of the neural system was 17.35%（76/376）and circulatory system was 16.44%（72/376），the deformative site were usually seen in sequence as follows: cleft of lip and palate（42/376） ,motorial system（32/376），urinary system（30/376），respiratory system（30/376），chromosomal disorder（26/376）and digestive system（20/376）. Among 376 cases，the cases of the single malformation were 243 (64.63%)，while the cases of multiple deformities were 133 (35. 37%). Conclusion Congenital malformation were the most important causes of mortality in fetal and perinatal. Clinical path