论文部分内容阅读
目的:探讨寄生胎(fetus-in-fetu,FIF)的临床特点、诊断及治疗,提高对FIF的认识。方法:对在南京大学医学院附属鼓楼医院出生的1例新生儿FIF的临床资料进行回顾性分析,以“寄生胎”、 “胎中胎”、“双胎畸形”、“畸胎瘤”和“fetus-in-fetu”、“parasitic twin”、“teratoma”为关键词对中国知网、维普、万方数据库、生物医学文献数据库及Embase生物医学全文数据库自2009年至2019年收录的文献进行检索,总结1周岁内发现的FIF患儿临床特征和诊疗要点。结果:本例患儿为足月女婴,母孕期超声检查提示胎儿骶尾部不规则混合性肿块,生后见肿块上有不完整的肢体形状,手术切除后恢复好,随访至4月龄生长发育正常。文献检索共收集53篇文献,包括本例共57例,其中男24例(42.1%),女30例(52.6%),未描述性别3例(5.3%);产前诊断11例(19.3%);寄生部位在腹膜后26例(45.6%);合并其他出生缺陷7例(12.3%);术后预后好45例(78.9%)。结论:FIF系罕见疾病,多见于腹膜后,产前诊断较难,应与畸胎瘤鉴别,治疗后预后较好。“,”Objective:To study the clinical features, diagnosis and treatment of fetus-in-fetu (FIF) for better understanding of FIF.Method:The clinical manifestations and treatments of one patient with FIF delivered in our hospital were analyzed. From 2009 to 2019, Chinese medical databases (CNKI, VIP, Wanfang database), Medline and Embase were searched using keywords including “parasitic twin”, “fetus-in-fetu” and “fetiform teratoma”. The clinical characteristics, diagnosis and treatment of infant FIF reported in the literature were reviewed and analyzed.Result:The case in our hospital was a full-term female infant. Fetal ultrasound indicated an irregular and mixed sacrococcygeal mass. After birth, incomplete limb-like organ was found on the mass. The surgical resection was successful and the overall development were normal at 4-month-old on follow-up. A total of 53 literatures were reviewed and 57 cases of FIF infants were collected (including this case). Among them, 24 were male (42.1%), 30 were female (52.6%) and 3 cases without gender description (5.3%). 11 cases were diagnosed before birth (19.3%). The parasitic mass were in retroperitoneal area in 26 cases (45.6%).7 cases had other birth defects (12.3%). 45 cases had good prognosis after surgery (78.9%).Conclusion:FIF is a rare disease and mostly found in retroperitoneal area.It is difficult to diagnose FIF before birth and teratoma should be ruled out. The prognosis of FIF is good after surgical treatment.