摘要
目的 利用超声技术评价产前发现的胎儿肾积水在出生后的转归情况 ,指导临床适时进行干预措施的实施。方法 对孕期发现肾盂积水的 48例新生儿的 87只肾 ,在生后 3天至 2 4个月期间定期进行超声检查 ,采用二维超声和彩色多普勒技术测定肾盂、肾盏、输尿管及肾血管阻力指数的变化。结果 肾盂积水程度 <15mm且≥ 10mm的 68只肾中 ,40只肾在生后 2 4个月内积水程度减轻或消失。肾盂积水程度≥ 15mm且 <2 0mm的 13只肾中 4只程度减轻 ,1只经手术解除梗阻。肾盂积水程度≥ 2 0mm的 6只肾中 ,5只经手术解除梗阻。肾血管阻力指数RI≥ 0 .7者肾盂积水程度均≥ 15mm。结论 孕期发现的肾盂积水出生后的转归与肾盂积水程度有关 ,超声技术可安全、方便、准确地反映其动态变化。
Objective To evaluate prognosis of fetal hydronephrosis after birth by ultrasound technique, and help clinician put intervention measure in practice at appropriate time. Methods 87 kidneys of 48 fetus were detected hydronephrosis, and routinely received ultrasound examination from 3 days to 24 months after birth .Variation of pelvic, caliceal, ureter and vascular resist index were measured by two-dimension ultrasound and colour dopplers technique.Results According to extent of hydronephrosis , classify three groups, in the first group pelvic diameter<15mm and ≥10mm, extent of hydronephrosis of 40 kidneys decreases or disappears spontaneously in all 68 kidneys; in the second group pelvic diameter≥15mm and <20mm, extent of hydronephrosis of 4 kidneys decreases spontaneously, 1 kidneys was operated in all 13 kidneys; in the third group pelvic diameter≥20mm, 5 kidneys were operated in all 6 kidneys. All vascular resist index≥0.7 with extent of hydronephrosis≥15mm.Conclusion Prognosis of hydronephrosis after birth related to the extent of hydronephrosis, ultrasound technique can reflect its dynamic derivation safely, conveniently, accurately.
