超声诊断先天性肾盂积水最终发展趋势的相关性研究

目的观察产前超声诊断先天性肾盂积水肾盂前后径（anteroposterlor renal pelvic diameter，APD）等数值的变化规律，探讨APD等相关数据在判断生理性或病理性肾盂积水中的临床价值。方法随访观察2011年4月至2013年2月69例行产前超声检查诊断为胎儿先天性肾盂积水患儿的临床资料，根据发展趋势分为生理性肾盂积水和病理性肾盂积水，并对两组积水APD值等相关数据进行比较分析。结果69例（73只肾）中，生理性肾盂积水55例（57只肾），积水多在产后1—6个月消失。病理性肾盂积水14例（16只肾），其中肾盂输尿管部梗阻12例（14只肾），膀胱输尿管部梗阻2例，未发现其它泌尿系统畸形。两组积水在胎儿性别、积水侧别、积水发生时间及孕30～33周前APD、肾皮质厚度（renal parenchyma thickness，RPT）、肾盏形态上比较，P〉0．05，差异无统计学意义。在孕30～33周及孕30～33周后APD、RPT、肾盏形态上比较，P〈0．05，差异有统计学意义。结论胎儿先天性肾盂积水最终发展趋势与胎儿性别、积水侧别、积水发生时间及孕30～33周前APD、RPT、肾盏形态无相关性；与孕30～33周及孕30—33周后APD、RPT、肾盏形态有相关性。在定期随访过程中，生理性肾盂积水多于产后1～6个月恢复正常，病理性肾盂积水的各项指标呈渐进性发展，需及时手术治疗。

Ultrasound diagnosis of congenital hydronephrosis to correlational research of ultimate development trend

Objetive To observe the numerical value change rule of anteroposterior renal pelvic diameter（APD） et al in prenatal ultrasound diagnosis of congenital hydronephrosis ,estimate the clinical value of relevant data of APD etc in judgment of the physiologic or pathologic hydronephrosis. Methods From April 2011 to February 2013,69 cases of fetal congenital hydronephrosis were diagnosed by prenatal ultrasound,all the cases were underwent a follow-up visit. According to their development tendency, the congenital hydronephrosis were distinguished into physiological hydronephrosis and pathological hydronephrosis. The relevant data of APD values of the two groups were followed a comparative analysis. Results In 69 cases of hydronephrosis （73 kidneys） ,55 eases （57 kidneys） suffered from physiological hydronephrosis and their hydronephrosis disappeared in 1 ~ 6 months postpartum; 14 cases （16 kidneys） suffered from pathological hydronephrosis, among which 12 patients （ 14 kidneys） had ureteropelvic junction obstruction and 2 cases had vesicoureteral junction obstruction, other urinary tract malformation was not found. Two groups of hydronephrosis have no statistical signifi- cances in fetal gender, the side of hydronephrosis, the time of occurrence and in the APD, renal parenchyma thickness （RPT） , calyx shape before 30 ~ 33 weeks of pregnancy （ P 〉 0.05 ）. And in or after 30 - 33 weeks of pregnancy have a statistieal significances in APD, renal parenehyma thickness （RPT） , calyx shape （P 〈 0. 05 ）. Conclusion There is no correlation between the ultimate development trends of congenital fetal hydronephrosis with the fetal gender,the side of hydronephrosis,the time of occurrence and the APD,RPT,calyx shape before 30 ~33 weeks of pregnancy. But in or after 30 ~33 weeks of pregnancy there is correlation with APD,RPT,calyx shape In the regular follow-up visit, the physiological hydronephrosis indicates still volatile in 38 -40 weeksof pregnancy,and most return to normal in 1 -6 months postpartum. Pathological hydronephrosis indicates graduallyincreasing, requires timely surgical treatment.