Changes in Lung Tissue Perfusion in the Prediction of Survival in Fetuses with Congenital Diaphragmatic Hernia Treated with Fetal Endoscopic Tracheal Occlusion
Changes in Lung Tissue Perfusion in the Prediction of Survival in Fetuses with Congenital Diaphragmatic Hernia Treated with Fetal Endoscopic Tracheal Occlusion
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DOI：
10.1159/000295262
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发表时间：
2011-01-01
影响因子：
2.2
通讯作者：
Gratacos, Eduard
中科院分区：
文献类型：
--
作者：
Cruz-Martinez, Rogelio;Moreno-Alvarez, Oscar;Gratacos, Eduard
目的：探讨经胎儿内镜气管闭塞术（FETO）治疗先天性膈疝（CDH）胎儿肺血流灌注分数（FMBV）对预测胎儿生存的影响。研究设计：对62例CDH胎儿进行FMBV肺灌注（%）和FETO前1天和FETO后7-14天观察/预期肺头比（o/e LHR）的评估，并评估其单独和联合预测生存的价值。结果：术前肺灌注与生存率无相关性。然而，FETO后，术前肺FMBV增加30%和LHR增加50%与生存概率显著相关。结合治疗后FMBV和o/e LHR变化的模型可以区分预后差（10%生存率）、中度（40-70%生存率）和预后极好（100%生存率）的病例。结论：FMBV评价FETO后肺组织灌注变化，提高了对CDH胎儿生存的预测。版权所有：S. Karger AG，巴塞尔
Objective: To assess the impact of lung perfusion by fractional moving blood volume (FMBV) for the prediction of survival in fetuses with congenital diaphragmatic hernia (CDH) treated with fetal endoscopic tracheal occlusion (FETO). Study Design: Lung perfusion by FMBV (%) and the observed/expected lung-to-head ratio (o/e LHR) were evaluated 1 day before and 7-14 days after FETO in a cohort of 62 CDH fetuses, and their isolated and combined values to predict survival was assessed. Results: Preoperative lung perfusion did not show association with survival. However, after FETO, an increase in 30% of the preoperative lung FMBV and an increase in 50% of the LHR was significantly associated with the probability of survival. A model combining the changes in FMBV and o/e LHR after therapy allowed discrimination of cases with poor (10% survival), moderate (40-70% survival) and very good prognosis (100% survival). Conclusion: Changes in lung tissue perfusion, evaluated by FMBV after FETO, improved the prediction of survival in fetuses with CDH. Copyright (C) 2010 S. Karger AG, Basel