胎儿肾盂分离超声测值与预测转归的价值  

The values of anteroposterior diameter in fetal renal pelvis separation and its value of predicting the prognosis

作　　者：董智芬 陈晓芳[1] 盛余敬[1] 张迎春[1] 

机构地区：[1]苏州大学附属第二医院超声中心,215004

出　　处：《中华医学超声杂志（电子版）》2017年第3期206-209,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的分析不同孕周胎儿肾盂分离(APD)的超声测值及临床预后。方法对2013年1月至2015年10月在苏州大学附属第二医院产前超声检查诊断为肾盂分离的182例胎儿均随访至产后12个月,分析最终发展为不可复性肾积水胎儿首次检出孕周及肾盂APD值。结果 182例胎儿中孕期首次检出肾盂分离46例,晚孕期首次检出肾盂分离136例(双侧肾盂分离92例)。随访过程中,114例肾盂分离在胎儿期自行恢复,52例在出生后12个月内恢复,仅16例(8.8%,16/182)发展为不可复性肾积水。16例不可复性肾积水胎儿中10例(62.5%,10/16)于中孕期检出肾盂分离,肾盂APD测值7.4~11.5 mm,平均(9.6±1.5)mm;6例(37.5%,6/16)于晚孕期检出肾盂分离,肾盂APD测值13.6~14.8 mm,平均(12.8±2.0)mm。结果显示,中孕期检出肾盂分离胎儿的肾盂APD测值小于晚孕期检出肾盂分离的胎儿,且中孕期检出肾盂分离的胎儿预后较差,其发展为不可复性肾积水的胎儿(21.7%,10/46)多于晚孕期检出者(4.4%,6/136)。结论产前超声动态观察胎儿肾盂径线,并结合首次检出肾盂分离的孕周及肾盂APD测值,有助于预测胎儿预后。Objective To analyze the values ofanteroposterior diameter （APD） in fetal renal pelvis separation during different gestational weeks and in predicting the prognosis. Methods Totally 182 cases of fetal renal pelvis separation in the Second Affiliated Hospital of Soochow University were enrolled in this study between January 2013 and October 2015. All of them were followed up to 12 months after birth. The detecting gestational weeks of non-reversible renal hydronephrosis and values of fetal renal pelvis APD were analyzed. Results Among the 182 cases of fetal renal separation, 46 cases were detected in the second trimester, 136 cases were detected in the third trimester （bilateral renal pelvis separation occurred in 92 cases）. During the follow-up, 114 cases recovered in the fetal period and 52 cases recovered within 12 months after birth, finally, 16 cases （8.8%, 16/182） of them progressed to non-reversible renal hydronephrosis. Among the 16 fetus of non-reversible renal hydronephrosis, 10 cases （62.5%, 10/16） were detected in the second trimester, their values of APD were 7.4-11.5 mm and the average was （8.0± 1.5） mm; 6 cases （37.5%, 6/16） were detected in the third trimester, their values of APD were 13.6-14.8 mm and the average was （12.8±2.0） mm. The values of APD in fetus who were detected in the second trimester were smaller than those in the fetus who detected in the third trimester and the prognosis in the fetus who were detected in the second trimester was worse than those in the fetus who were detected in the third trimester, the fetus （21.7%, 10/46） who progressed to non-reversible renal hydronephrosis in the second trimester were more than the fetus （4.4%, 6/136） who were detected in the third trimester. Conclusion Clinical following-up combined with the detecting gestational weeks of fetal renal pelvis separation and values of fetal renal plevis APD by prenatal ultrasound may be helpful in predicting their prognosis.

关 键 词：超声检查 产前 胎儿 肾盂积水 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]