产前诊断肾盂扩张结局的前瞻性研究。
Prospective study of outcome in antenatally diagnosed renal pelvis dilatation.
作者信息
Jaswon M S, Dibble L, Puri S, Davis J, Young J, Dave R, Morgan H
机构信息
Department of Paediatrics, Whittington Hospital NHS Trust, Highgate Hill, London.
出版信息
Arch Dis Child Fetal Neonatal Ed. 1999 Mar;80(2):F135-8. doi: 10.1136/fn.80.2.f135.
AIMS
To ascertain the outcome associated with antenatal renal pelvis dilatation; to recommend guidelines for postnatal investigation and determine an upper limit of normal for the anterioposterior dimensions of the fetal renal pelvis.
METHODS
Infants whose antenatal ultrasound scan showed a fetal renal pelvis of 5 mm or greater were investigated using postnatal renal tract ultrasound and a micturating cystogram. Isotope studies were also performed, where appropriate.
RESULTS
Vesicoureteric reflux (VUR), the most common diagnosis, was evident in 23/104 (22%). In 14 infants with VUR the postnatal ultrasound scan was normal. There was no evidence of renal scarring or dysplasia in any of the refluxing kidneys. Other diagnoses were pelviureteric junction obstruction, renal dysplasia, and idiopathic dilatation. Antenatal counselling and parental information facilitated postnatal assessment.
CONCLUSIONS
Infants with antenatal renal pelvis measurements of 5 mm or greater should be investigated postnatally, as a significant percentage will have VUR. A normal postnatal ultrasound scan does not preclude the presence of VUR.
目的
确定产前肾盂扩张的相关结局；推荐产后检查指南并确定胎儿肾盂前后径的正常上限。
方法
对产前超声扫描显示胎儿肾盂直径达5毫米或更大的婴儿进行产后肾脏超声检查及排尿性膀胱尿道造影。必要时也进行同位素检查。
结果
膀胱输尿管反流（VUR）是最常见的诊断结果，在104例中有23例（22%）出现。14例有VUR的婴儿产后超声扫描结果正常。所有反流性肾脏均未发现肾瘢痕或发育异常。产前咨询和向家长提供信息有助于产后评估。
结论
产前肾盂测量值达5毫米或更大的婴儿应在产后进行检查，因为相当比例的婴儿会有VUR。产后超声扫描结果正常并不能排除VUR的存在。
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