胎儿肾囊性疾病的超声诊断和预后  

The ultrasound diagnosis and prognosis of the featal renal cystic diseases

作　　者：时春艳[1] 金燕志[1] 陈倩[1] 周世梅[1] 柳平[2] 

机构地区：[1]北京大学第一医院妇产科,北京100034 [2]北京大学第一医院病理科,北京100034

出　　处：《中国优生优育（1990-2002上半年）》2001年第2期49-52,F003,共5页Journal of Improving Birth Outcome and Child Development of China

摘　　要：目的 探讨胎儿肾囊性疾病的超声诊断和预后。方法 回顾性分析1998年8月～2000年7月3158例孕妇产前超声诊断的4例胎儿肾囊性疾病的超声特点,预后判断及新生儿情况追踪。结果 4例胎儿肾囊性疾病中无羊水1例行中期引产,尸解病理证实为双侧多囊性肾发育不良;羊水过少1例为死产,尸解病理证实为双侧肾盂输尿管接口处狭窄;2例羊水量正常足月分娩,1例已健康生存1年零1个月,生后半年超声检查右肾仍呈多囊状,但体积缩小,左肾囊肿消失,形态及肾功能正常;1例生后染色体检查为21-三体,生后2个月超声检查双肾囊肿消失,左肾盂轻度扩张。4例病例1例在妊娠23周诊断,其余3例均在孕晚期诊断。结论 孕中、晚期超声检查有利于胎儿肾囊性疾病的检出;羊水的多少及有无染色体异常与胎儿预后有关;胎儿肾囊性病变生后有可能消失或缩小。Objective To investigate the prenatal ultrasound diagnosis and prognosis of the fetal renal cystic diseases Methods The sonographic features and the prognosis of 4 fetuses with renal cystic diseases diagnosed by ultrasound among 3 158 preanant women from August 1998 to July 2000 were studied. Results Of the four cases, one with anhydramnios was terminated at 24 weeks of gestation and the pathologic anatomy showed bilateral multicystic dysplastic kidney disease; one with oligohydramnios was stillbirth and the pathologic anatomy showed bilateral obstructive cystic kidneys; the other two cases with normal amiotic fluid index were deliverd at term. One baby is already one year and two months old, alive healthly. The right kidney is still multicystic but decreased in size and the left kidney is normal completely and the renal function is normal. Another baby is Down syndrome diagnosed by chromosome examination after birth and the renal cysts of the two kidney completely involute at the age of two monthes. Conclusion The ultrasound examination in the second and third trimester is useful in diagnosing the fetal renal cystic disease. Anhydramnios or oligohydramnios and with or without chromosome abnormality is the sticking point in the evaluation of the prognosis. Serial ultrasound examination suggests that the cystic lesions can involute with time.

关 键 词：肾囊性疾病 胎儿 超声波检查 预后 

分 类 号：R714.5[医药卫生—妇产科学]