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表4 不同类型MP的临床表现及治疗方式
Table 4 Clinical manifestation and treatments of MP with different classification
Clinical Intestinal obstruction Peritonitis
Asymptomatic
features Complete Incomplete Diffuse peritonitis Localized peritonitis
Clinical None Severe vomiting; Minor vomiting; Severe toxemia; Mild symptoms;
presentation constipation; mild abdominal significant abdominal intermittent vomiting;
significant distension; distension; able to eat and pass
abdominal normal compromised stools
distension defecation respiration
Imaging Calcifications Scattered Calcifications; Multiple Calcifications;
findings calcifications; minimal calcifications; encapsulated
dilated bowel loops; dilatation of bowel multiple intestinal pneumoperitoneum;
step ladder gas⁃fluid loops; adhesions; meconium pseudocyst
levels; pelvic gas; subdiaphragmatic free
ascites; less gas⁃fluid levels gas
subdiaphragmatic
free gas
Treatments Informed of risks Urgent surgery Conservative Urgent surgery Subacute surgery or
and close clinical treatment conservative treatment
follow⁃up
定诊疗方案意义重大,同时需结合临床表现及实验 aschall Der Medizin,2022,43(2):194-203
室检查,对于呕吐、腹胀明显,或感染指标较高的患 [3] PING L M,RAJADURAI V S,SAFFARI S E,et al. Meco⁃
儿,手术治疗的效果好于单纯的对症治疗,也能避 nium peritonitis:correlation of antenatal diagnosis and
免危重并发症的发生。 postnatal outcome ⁃ an institutional experience over 10
3.3 不足与未来方向 years[J]. Fetal Diagn Ther,2017,42(1):57-62
[4] 刘向娇,周佳亮,尚 宁,等. 胎粪性腹膜炎的产前超声
本研究存在一定的不足,如样本量较少,未与
分级与预后分析[J]. 中国超声医学杂志,2021,37(8):
产前超声相结合,且本研究为回顾性分析,较难确
904-906
定影像学结果对最终是否决定手术的影响程度,但
[5] 郭卫红,陈永卫,侯大为,等. 先天性肠闭锁病死率 40
影像学检查结果的重要性不容忽视。未来可建立 年回顾性分析[J]. 中华小儿外科杂志,2011,32(6):
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综上,超声联合放射学检查是评估 MP 患儿是 预后相关因素分析[J]. 上海交通大学学报(医学版),
否需要手术的有力工具,高度提示需要手术治疗的 2020,40(5):662-665
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影像表现为肠梗阻、腹水、肠扭转和气腹。患儿单
select fetuses with intra⁃abdominal calcification for deli⁃
纯出现弥漫性腹腔钙化或假性囊肿时,可保守治
very in neonatal surgical centres?[J]. J Pediatr Surg,
疗,但需注意结合患儿一般情况及实验室指标,避
2013,48(5):946-950
免延误病情。 [8] CHEN C W,PENG C C,HSU C H,et al. Value of prena⁃
[参考文献] tal diagnosis of meconium peritonitis:comparison of out⁃
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[1] WONG C W Y,WONG K K Y. Meconium peritonitis:a 22
(Baltimore),2019,98(39):e17079
⁃ year review in a tertiary referral center[J]. J Pediatr [9] 江肖松,关 键,林 玲,等. 假囊肿型胎粪性腹膜炎的
Surg,2022,57(8):1504-1508 产前MRI和产后CT影像表现[J]. 中国医学影像技术,
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