孕28~32周针对性超声筛查胎儿肾盂分离  

Targeted ultrasound screening of fetal hydronephrosis at 28-32 gestational weeks

作　　者：张会萍 周毓青 龚菁菁 陈田田 何碧媛 ZHANG Huiping;ZHOU Yuqing;GONG Jingjing;CHEN Tiantian;HE Biyuan(Department of Medical Ultrasonics,Shanghai Changning Maternity and Infant Health Hospital,Maternity and Infant Health Hospital,East China Normal University,Shanghai 200051,China)

机构地区：[1]上海市长宁区妇幼保健院华东师范大学附属妇幼保健院超声医学科,上海200051

出　　处：《中国介入影像与治疗学》2021年第7期402-405,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：上海市医学(产科)重点专科项目(ZK2019B02)。

摘　　要：目的于孕28~32周以超声针对性筛查胎儿肾盂分离情况,观察其临床意义。方法针对性观察接受常规产检的孕28~32周单胎孕妇胎儿肾盂情况。根据肾盂最大前后径(APD)将肾盂分离分为肾盂轻度分离组(轻度组)及重度分离组(重度组),回顾性分析2组胎儿孕18~24周有无肾盂分离,前瞻性观察孕37~40周肾盂分离转归。结果共37890只胎肾入组,孕28~32周见223只肾盂分离(0.59%,223/37890),轻度组178只,重度组45只。孕18~24周时,轻度组20只无肾盂分离,126只轻度肾盂分离,32只重度肾盂分离;重度组1只无肾盂分离,18只轻度肾盂分离,26只重度肾盂分离;2组肾盂分离程度差异有统计学意义(P<0.01)。孕37~40周时,轻度组65只无肾盂分离,61只轻度肾盂分离,52只重度肾盂分离;重度组12只无肾盂分离,3只轻度肾盂分离,30只重度肾盂分离;2组胎儿肾盂分离程度差异有统计学意义(P<0.01)。结论胎肾肾盂分离呈动态变化,孕28~32周针对性超声检查有助于及时检出持续性肾盂分离及重度肾盂分离。Objective To observe the clinical significances of targeted ultrasound screening of fetal hydronephrosis at 28-32 gestational weeks.Methods Gravidas with singleton who underwent ultrasound examinations at 28-32 gestational weeks were targeted screened to observe the presence of fetal hydronephrosis.The fetal kidneys with hydronephrosis were divided into mild group and severe group,and the ultrasonic findings of these kidneys at 18-24 gestational weeks were retrospectively analyzed,whereas the outcomes of these kidneys at 37-40 gestational weeks were prospectively analyzed.Results A total of 37890 fetal kidneys at 28-32 gestational weeks enrolled,including 223(0.59%,223/37890)with hydronephrosis.There were 178 fetal kidneys in mild group and 45 in severe group.During 18-24 week gestation,20 had no hydronephrosis,126 kidneys had mild hydronephrosis and 32 kidneys had severe hydronephrosis kidneys in mild group,while 1 kidney had no hydronephrosis,18 kidneys had mild hydronephrosis and 26 kidneys had severe hydronephrosis in severe group,and the distribution of fetal hydronephrosis were significantly different between groups(P<0.01).During 37-40 week gestation,65 kidneys had no hydronephrosis,61 kidneys had mild hydronephrosis and 52 kidneys had severe hydronephrosis in mild group,while 2 kidney had no hydronephrosis,3 kidneys had mild hydronephrosis and 30 kidneys had severe hydronephrosis in severe group,and the distribution of fetal hydronephrosis were significantly different between groups(P<0.01).Conclusion Fetal hydronephrosis changed dynamically.Targeted ultrasound screening at 28-32 gestational weeks was helpful to dynamic observation of persistent or severe hydronephrosis,providing valuable information for further examination and clinical management.

关 键 词：肾盂 胎儿 超声检查 产前 肾盂分离 

分 类 号：R715.9[医药卫生—妇产科学] R445.1[医药卫生—临床医学]