目的：探讨超声诊断胎儿肾盂分离的临床意义及产前肾盂宽度的变化趋势。方法回顾性分析中期妊娠行超声筛查的13500例孕妇中检出胎儿肾盂前后径宽度（Renal Pelvis Anteroposterior Diameter,RPAPD）≥4 mm且无其他畸形的114例胎儿超声资料。结果胎儿的RPAPD的大小与孕妇年龄之间无明显差异（P=0.062）>0.05；中期妊娠胎儿单侧RPAPD72例（63.15%）多于胎儿双侧RPAPD42例（36.84%）；分娩前胎儿单侧RPAPD＜10mm的有69例（66.35%）多于胎儿双侧RPAPD35例（33.65%）；胎儿肾盂持续性进行性分离≥10 mm单侧3例（30%）少于双侧7（70%）；分娩前RPAPD＜10 mm与持续性进行性RPAPD≥10 mm组间进行分类变量的卡方检验，P=0.0023<0.05，具有统计学意义。结论中期妊娠超声诊断单纯胎儿RPAPD（4～10 mm）的患者大部分在分娩前RPAPD＜10 mm，RPAPD≥10 mm的患者在分娩前持续性扩张。超声跟踪监测胎儿RPAPD，能及时准确提供产前信息。%Objective To assess the clinical significance of isolated fetal renal pyelectasis and its changes in utero. Methods One hundred and fourteen isolated pyelectasis cases with their RPAPD (Renal Pelvis Anteroposterior Diameter) ≥ 4 mm without other fetal anomaly who were screened from 13500 pregnant women by using ultrasound were retrospectively reviewed. Results There was no obvious difference between RPAPD and the age of pregnancy (P=0.062)>0.05; 72 cases (63.15%) were one sided renal pyelectasis, more than 42 cases (36.84%) of renal pyelectasis were on both sides; 69 cases (66.35%) were one sided renal pyelectasis and RPAPD < 10 mm before delivery, more than 35 cases (33.65%) with bilateral renal pyelectasis and RPAPD < 10 mm; 3 cases with RPAPD ≥ 10 mm (30%) and one sided renal pyelectasis were treated with continuous renal pelvis separation, less than 7 cases with RPAPD≥ 10 mm (70%) and bilateral renal pyelectasis; According to the Chi-square test between two groups (RPAPD < 10mm Before Gelivery Group and RPAPD ≥ 10 mm Continuous Renal Pelvis Separation Group), the difference was statistically significant (P=0.0023<0.05). Conclusion Although most of the fetuses with RPAPD ranging from 4 to 10 mm in second trimester would remain the same or resolved before delivery, those with RPAPD ≥ 10 mm might continuously expand. Tracking and monitoring of fetal renal pelvis by using ultrasound could provide proper prenatal consultation.
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