Objectives: To investigate the prenatal diagnosis of severe primary fetal hydrothorax and the clinical outcome after intrauterine thoracentesis.
Methods: A total of 12 patients with severe PFHT and thoracentesis, who were admitted to Xiangya Hospital, Central South University from January 2016 to December 2018, were enrolled. The clinical data were retrospectively analyzed.
Results: Five cases were bilateral pleural effusion, 6 on the right side, and 1 on the left side. All cases were accompanied with polyhydramnios, 4 cases with ascites, and 3 cases with skin edema. Ten patients underwent 1 thoracentesis puncture, 1 case for twice, and 1 case for 5 times. Hydrothorax test results of all cases were consistent with primary pleural effusion. Three patients underwent labor induction, 4 of 9 live births had mild asphyxia, 8 required respiratory support, and 7 needed the closed thoracic drainage. All children were fed with medium-chain fatty acid milk powder.
Conclusions: Thoracentesis is one of the measures for intrauterine intervention in severe PFHT, which can improve the prognosis of children. Respiratory support, closed thoracic drainage, medium-chain fatty acid feeding are given to newborn. After these treatments, the survival rate is high and the prognosis is good.
目的: 探讨胎儿重度原发性胸腔积液的产前诊断及胸腔穿刺后的临床转归。方法: 选取2016年1月至2018年12月中南大学湘雅医院收治的重度原发性胸腔积液并行胸腔穿刺的患者12例，对其临床资料进行回顾性分析。结果: 5例患者为双侧胸腔积液，6例单发于右侧，1例单发于左侧。12例患者均合并羊水过多，4例伴有腹水，3例出现皮肤水肿。10例患者行胸腔穿刺1次，1例穿刺2次，1例穿刺5次。12例患者的胸水检查结果均符合原发性胸腔积液改变。3例患者引产，9例活产儿中4例轻度窒息，8例需要呼吸支持，7例行胸腔闭式引流。活产儿均予中链脂肪酸奶粉喂养，治疗后均痊愈出院。结论: 胸腔穿刺是重度原发性胸腔积液胎儿宫内干预的措施之一，患儿出生后进行呼吸支持、胸腔闭式引流、中链脂肪酸喂养等处理，存活率高，预后好。.
Keywords: fetal edema; fetal pleural effusion; intrauterine treatment; thoracic puncture; thylothorax.