产前超声诊断63例胎儿肾积水及出生后动态观察

摘要

目的 探讨产前超声诊断胎儿肾积水及出生后动态观察.方法 对2006年1月至2011年12月该院行产前超声检查的孕妇63例(75只肾)的胎儿肾积水发生的时间、积水程度、肾实质的厚度、肾血管阻力指数(RI)、羊水指数及有无伴随畸形等进行随访分析.结果 Ⅰ级43例(44只肾)与Ⅱ级10例(20只肾)积水消退.Ⅲ级5例(7只肾)中2例引产,3例手术治疗.Ⅳ级4例(4只肾)均手术治疗.Ⅴ级1例(1只肾)手术治疗.结论 对于胎儿肾盂积水产前及产后Ⅰ级、Ⅱ级肾盂积水可自然消退,Ⅲ级以上肾盂积水大部分需要手术治疗,预后好.%Objective To investigate the effects of prenatal ultrasound on diagnosing fetal hydronephrosis and the dynamic ob servation after delivery. Methods 63 pregnant women with fetal hydronephrosis(75 kidneys) diagnosed by prenatal ultrasound de tection in this hospital from January 2006 to December 2011 were selected and performed the follow up analysis on the onset time. hydronephrosis degree, thickness of renal parenchyma, resistance index(RI) of renal arteries ,amniotic fluid index and accompanying congenital malformations. Results In 63 cases of fetal hydronephrosis,51 cases were unilateral and 12 cases were bilateral. Hydro nephrosis in 43 cases(44 kidneys) of the grade I and 10 cases(20 kidneys) of the grade II all were subsided. Among 5 cases(7 kid neys) of the grade III ,2 cases were performed induced labor and the other 3 cases received operation. 4 cases(4 kidneys) of the grade IV and 1 case(l kidney) of the grade V received the surgical treatment. Conclusion The grade T and II hydronephrosis could spontaneously regress and the grade III or above mostly require surgery with good prognosis.