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胎儿肾积水的超声诊断及转归分析
引用本文:宋江虹,白安胜,杨宗仁.胎儿肾积水的超声诊断及转归分析[J].现代泌尿外科杂志,2008,13(5):347-349.
作者姓名:宋江虹  白安胜  杨宗仁
作者单位:1. 延安大学附属医院超声科,陕西延安,716000
2. 延安大学附属医院泌尿外科,陕西延安,716000
摘    要:目的用超声方法检测胎儿肾积水程度与出生后积水肾的转归情况。方法选择2000年9月至2007年6月我院门诊就诊的单胎孕妇,应用超声检查筛选并随访肾积水胎儿163例(221侧)积水胎肾,随访时间最长为2.5年,同期测量15孕周至40孕周正常胎儿肾脏,记录肾脏集合系统内径及肾皮质厚度。结果正常胎儿的肾脏在孕28—32周可以测量到7mm左右集合系统的分离,肾脏皮质厚度均在5mm以上;本组胎肾集合系统前后径分离值10~15mm者:Ⅰ组,165侧,其中皮质厚度在5mm以下者37侧,6侧手术治疗;集合系统前后径〉15mm者:Ⅱ组,56侧,皮质厚度〉5mm的42侧中3侧手术治疗,皮质厚度5mm以下14侧,其中11例手术治疗。结论产前胎儿肾积水大部分都是生理性的,可随着个体的发育而自发消退,对于生后仍存在肾积水的患儿,应定期随访观察;超声检查显示肾集合系统前后径〉15mm,肾皮质厚度〈5mm的胎儿肾积水往往存在病理性梗阻,应高度重视。

关 键 词:胎儿  肾积水  超声检查

Ultrasonography and prognosis of fetal hydronephrosis
Song Jianghong,Bai Ansheng,Yang Zongren.Ultrasonography and prognosis of fetal hydronephrosis[J].Journal of MOdern Urology,2008,13(5):347-349.
Authors:Song Jianghong  Bai Ansheng  Yang Zongren
Institution:Song Jianghong , Bai Ansheng , Yang Zongren (1. Department of Ultrasound; 2. Department of Urology, the Affiliated Hospital of Medical College of Yan'an University, Yan'an 716000, China)
Abstract:Objective To study the relationship between the extent of fetal hydronephrosis and the prognosis of hydronephrosis. Methods 163 fetuses (221 kidneys) with hydronephrosis were detected from September 2000 to June 2007, and followed up by ultrasonography, the longest follow up being 2.5 years. The kidneys of normal fetuses with 15 to 40 gestational weeks were surveyed by ultrasonography at the same time. Inner diameter of the pelvis and thickness of parenchyma were noted. Results About 7mm of pyelic distension and thicker than 5 mm of parenchyma could be found in normal fetuses. In fetuses with hydronephrosis, there were 165 kidneys with inner diameter of the pelvis dilating to 10 mm to 15 mm and the parenchymal thickness was less than 5 mm in 37 kidneys, 6 treated by operation; there were 56 kidneys with inner diameter of pelvis dilating more than 15 mm, 42 kidneys' parenchymal thickness was more than 5 mm, 3 of which were operated; the other 14 kidneys' parenchymal thickness was less than 5 mm and 11 of them were operated. Conclusion Most hydronephrosis in fetus is physiological change which can disappear with individual development. Children with hydronephrosis after birth should be followed up regularly. More attention should be paid to the fetal hydronephrosis with pelvis dilating more than 15 mm and parenchymal thickness less than 5 mm because pathological obstruction may exist.
Keywords:fetus  hydronephrosis  ultrasonography
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