产前肾脏超声诊断在胎儿肾积水诊断中的应用  

Application of Prenatal Renal Ultrasound Diagnosis in Fetal Hydronephrosis Diagnosis

作　　者：林文通 饶丽平 林琳 LIN Wentong;RAO Liping;LIN Lin(Department of Ultrasound,the First Affiliated Hospital of Fuzhou,Fujian Medical University,Fuzhou Fujian 350009,China)

机构地区：[1]福建医科大学附属福州市第一医院超声科,福建福州350009

出　　处：《中国卫生标准管理》2024年第13期23-26,共4页China Health Standard Management

摘　　要：目的探讨产前肾脏超声诊断在胎儿肾积水诊断过程中的应用及预后转归分析。方法选取2020年1月—2023年12月福建医科大学附属福州市第一医院就诊经胎儿肾脏超声筛查的单胎肾积水胎儿35例作为临床研究对象,观察正常15~40孕周胎儿肾脏超声检查结果,分析肾积水胎儿预后与胎儿集合系统前后径以及肾皮质厚度的关系。结果胎儿肾脏超声筛查的单胎肾积水胎儿共35例,均为单肾,均发生不同程度的肾积水情况,其中9例为病理性肾积水,26例为非病理性肾积水。在非病理性肾积水中,可见肾小盏出现了明显扩张表现,且肾实质明显变薄等表现。肾脏超声结果显示,34~37孕周及38~40孕周胎儿的集合系统前后径值以及肾皮质厚度均明显高于15~28孕周胎儿,正常胎儿约在34孕周可检测到约7 mm的集合系统前后径,此时胎儿肾皮质厚度约为5 mm。35例肾积水胎儿在出生后3个月内有22例肾积水消失,集合系统前后径>15 mm且肾皮质厚度≤5 mm的胎儿未出现肾积水消失,其余有8例肾皮质厚度≤5 mm者接受手术。结论产前超声诊断检查能有效判断胎儿肾积水状态,作为临床早期无创检测具有良好的准确率;但针对出生后仍有肾积水的患儿,应警惕病理性梗阻的可能,重视临床随访,必要时进行手术治疗。Objective To explore the clinical application of prenatal renal ultrasound in the early diagnosis and prognosis of fetal hydronephrosis.Methods A total of 35 cases of single fetus with hydronephrosis who came to the First Affiliated Hospital of Fuzhou,Fujian Medical University from January 2020 to December 2023 and underwent ultrasonic screening of fetal kidney were selected as clinical research objects.The results of ultrasonic examination of fetal kidney between 15 to 40 weeks of normal gestation were observed,and the relationship between the prognosis of fetus with hydronephrosis and the diameter of fetal collection system and the thickness of renal cortex were analyzed.Results A total of 35 cases of single fetus with hydronephrosis were screened by fetal kidney ultrasound,all of which were single kidneys and had different degrees of hydronephrosis,including 9 cases with pathological hydronephrosis and 26 cases with non-pathological hydronephrosis.In the non-pathological hydronephrosis,the renal calicae showed obvious dilation and the renal parenchyma was obviously thinning.The renal ultrasound results showed,34-37 gestational age and 38-40 gestational weeks of fetal size before and after the collection system of values,and renal cortical thickness were significantly higher than that of 15-28 gestational fetus,normal fetus can be detected in about 34 weeks gestation about 7 mm diameter before and after the collection system,the fetal renal cortical thickness of about 5 mm.In the 35 cases,22 cases of hydronephrosis disappeared within 3 months after birth.No hydronephrosis disappeared in the fetuses with anteroposteric diameter of the collecting system greater than 15 mm and the thickness of the renal cortex≤5 mm.The remaining 8 cases with the thickness of the renal cortex≤5 mm received surgery.Conclusion Prenatal ultrasound diagnosis can effectively determine the status of fetal hydronephrosis and has a good accuracy as a noninvasive detection in early clinical stage.However,for children with hydronephrosis

关 键 词：胎儿肾脏超声 胎儿肾积水 临床应用 早期诊断 手术 随访 

分 类 号：R692[医药卫生—泌尿科学]