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中国临床研究英文版:2020,33(5):679-681
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胎儿肾盂积水的超声诊断及预后分析
(1.唐山市妇幼保健院超声科,河北 唐山063000;2.唐山市妇幼保健院放射科,河北 唐山063000)
Ultrasound diagnosis and prognosis of fetal hydronephrosis
摘要
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Received:July 19, 2019   Published Online:May 20, 2020
中文摘要: 目的 探讨不同胎龄胎儿肾脏集合系统分离或扩张的变化、转归及预后。方法 从中晚期妊娠孕妇中筛选胎儿集合系统扩张肾脏、定期复查至足月312只肾脏,以肾盏扩张程度分组,结合肾脏横切面前后径(APD)测量值及肾实质厚度改变。胎儿时期及出生后分为3个阶段随访,观察不同时期肾积水的变化、转归。结果 220只肾脏于出生前或出生后4个月内肾盂分离无进行性加重或转归为正常;64例患儿出生后1年内手术治疗,诊断为30例先天性肾盂输尿管交界处梗阻,重复肾14例,10例先天性巨输尿管,输尿管第三段狭窄8例,2例输尿管囊肿,患儿出生后4个月~2岁手术治疗,术后患侧肾脏肾功能良好;未手术的28只肾盂积水肾脏,观察期内肾盂积水程度无明显增加,肾功能检查正常。结论 以胎儿肾脏肾盏扩张程度结合APD值测量及肾实质厚度测量综合评价肾积水程度更加客观。胎儿肾盂分离于出生前后大部分可恢复正常,胎儿中度、重度肾积水需密切随访,胎儿出生后早期手术治疗,预后较好。
Abstract:ObjectiveTo analyze the changes,outcomes and prognosis of dilatation or separation of the fetal renal collecting system at different gestational ages.MethodsFrom the women in mid to late pregnancy,312 kidneys of dilated renal collecting system were screened and grouped according to the degree of renal calyx dilatation,the value of anteroposterior diameter (APD) of renal and renal parenchymal thickness.From fetal to postnatal stages,the changes and outcomes of hydronephrosis were observed during three follow-up times.ResultsThere was no progressive aggravation or normalization of renal pelvis separation in 220 kidneys before and 4 months after birth.In 64 cases of undergoing surgical treatment within 1 year after birth,there were 30 cases of congenital ureteropelvic junction obstruction,14 cases of duplicate kidney,10 cases of congenital megaureter,8 cases of upper third ureteral stenosis and 2 cases of ureteral cyst.The renal function of the affected side was good after operation in the infants operated between 4 months and 2 years after birth.No significant increase in hydronephrosis was found in 28 kidneys without surgical procedure,and the renal function was normal during the observation period.ConclusionsIt is more objective to evaluate the degree of hydronephrosis with fetal pelvicalyceal dilatation combined with APD value and renal parenchymal thickness.In most cases,the fetal renal pelvis separation can return to normal before and after birth.The infants with moderate and severe hydronephrosis should be closely followed up,and early surgical treatment after birth has a good prognosis.
文章编号:     中图分类号:    文献标志码:B
基金项目:河北省医学课题研究重点课题计划(20171333)
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