| 余仙娟,黄晓颖,汝触会,何飞.IVF-ET后先天性结核双胞胎报道及文献复习[J].浙江中西医结合杂志,2021,31(1): |
| IVF-ET后先天性结核双胞胎报道及文献复习 |
| References |
| 投稿时间：2020-01-02 修订日期：2020-03-24 |
| DOI： |
| 中文关键词: 先天性结核 体外受精-胚胎移植 双胞胎 |
| 英文关键词: |
| 基金项目: |
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| 摘要点击次数: 464 |
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| 中文摘要: |
| 目的 提高临床医生对IVF-ET术后先天性结核感染途径、预防措施、临床表现、诊断方法、治疗及预后的认识。方法 回顾分析1例经IVF-ET(体外受精-胚胎移植)成功妊娠并在妊娠期间出现急性粟粒性结核产下先天性结核双胞胎病例,通过关键词检索文献,对文献报道的IVF-ET术后18例先天性结核患儿及14例(5例母亲产双胞胎)母亲临床情况进行分析并文献回顾。结果 母亲结核：产前活动3例,产后7例,未活动5例；先天性结核：男性9例,女性11例,临床表现无明显特异性。胸片主要为弥漫性病变,右肺多发。CT可见结节、实变、空洞、钙化病变。15例患儿抗结核治疗后好转。结论 IVF-ET后先天性结核较罕见,其临床表现、影像学表现缺乏特异性,加之临床医生对该病缺乏足够的认识,常延误诊治。多胎妊娠可能加重母亲及胎儿结核患病风险；当双胞胎之一被确诊先天性结核,建议对有症状的另一胎儿行诊断性抗结核治疗。IVF-ET术前结核筛查及治疗,快速的诊断及抗结核治疗对降低先天性结核病死率效果显著。 |
| 英文摘要: |
| Objective To improve the knowledge of congenital tuberculosis after IVF-ET(in vitro-fertilization embryo transfer)in infection pathway, clinical manifestation, diagnosis method, treatment methods and prognosis. Methods Report and analysis a case of a pair of twins, who diagnosed with congenital tuberculosis after IVF-ET. Database was searched using keywords for congenital tuberculosis after IVF-ET related literature. Summarize the information of the 18 infants and the 14 mothers(5 were twin pregnancy) with congenital tuberculosis after IVF-ET and review of the literatures. Result 3 mothers were diagnosed with active tuberculosis during pregnancy, 7 were diagnosed after giving birth and 5 had no clinical manifestations were diagnosed with latent tuberculosis. The main clinical manifestations of congenital tuberculosis were nonspecific. Chest radiographs mostly showed lesions in bilateral lungs, and in right lung more than in left lung. Computed tomography showed as nodule, consolidation, cavity and calcification. 15 children were recovery after anti-tuberculosis treatment. Conclusion Congenital tuberculosis after IVF-ET is rare and the diagnosis is difficult because the clinical manifestations and imaging performance lack of specificity．Patients even die before getting proper treatments．Multiple pregnancy increases the incidence rate of tuberculosis after IVF-ET both the maternal and fetal. Anti-tuberculosis was recommended to start on the symptomatic infant when the sibling was diagnosed with congenital tuberculosis. Screening and treatment of tuberculosis that leads to infertility before IVF-ET, rapid diagnosis and anti-tuberculosis, can significantly reduce the mortality of congenital tuberculosis. |
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