彩色多普勒超声对预测胎儿肾盂分离转归的应用价值

目的应用彩色多普勒超声动态观察胎儿肾盂分离状态,为预测胎儿肾盂分离的转归、避免不必要的终止妊娠、及早治疗泌尿系统先天畸形,提供有价值的信息。方法选择2008年10月—2010年1月在我院就诊的单胎孕妇,符合纳入排除标准者,首次超声提示胎儿肾盂分离[采用Stocks等[1]标准,孕33周以前肾盂前后径（APD）≥4 mm,孕33周以后APD≥7 mm作为肾盂分离的标准]共119例。从首次发现胎儿肾盂分离开始,孕妇每隔4周进行1次超声检查复查;出生后1年内,每月复查1次超声,观察胎儿的转归。将所有数据录入计算机,用SPSS11.5软件处理。结果 （1）可复组与不可复组胎儿肾脏APD值差异有统计学意义。（2）通过绘制受试者工作特征曲线（ROC曲线）,得出对于妊娠≥33周孕妇预测其胎儿肾盂分离转归有意义的APD界值为15.5 mm。结论 APD值≥15.5 mm时,发展为不可复性肾积水的可能性大。

The application value of color doppler ultrasonography in predicting the final outcome of a fetal renal pelvis separation

Objective The application value of color doppler ultrasonography in predicting the final outcome of a fetal renal pelvis separation was designed for the prediction of the renal pelvis separation fetus outcome,the unnecessary damage of termination of pregnancy,and the Early treatment of the urinary system congenital malformation.Methods The pregnant women who had a fetal from October 2008 to January 2010 in our hospital were reviewed.Inclusion criteria： First time ultrasonic hint fetal renal pelvis separation（the standard of Stocks etc[1]： the standard of a fetal renal pelvis separation was renal pelvis APD ≥4mm before pregnant 33 weeks,renal pelvis APD ≥7mm after pregnancy 33 weeks）.There are total 119 cases.Pregnancy that first discovered renal pelvis separation from fetal began,pregnant women must have an ultrasound re-examination every 4 weeks,after the birth of neonatal to 1 year,monthly review within an ultrasonic parturition,finally observe the final outcome.All the data collected will be computerized with SPSS11.5 software process.Results（1）The difference of fetal kidney APD value between reducible group and irreducible group was statistically significant.（2）Through the receiver-operating characteristic curve（characteristic curve,receive operating ROC curves）,predict the fetal renal pelvis separation outcome of pregnant women whose pregnancy ≥ 33 weeks and the meaningful APD boundary value（15.5 mm） is obtained.Conclusion If APD ≥ 15.5 mm,there is great possibility to develop into irreducible hydronephrosis.