Audry G, Montagne J P, Bruézière J
Service de Chirurgie Viscérale Pédiatrique, Hôpital Trousseau, Paris.
Ann Urol (Paris). 1992;26(4):197-201.
The major benefit of antenatal ultrasonography is to allow early diagnosis of urinary tract malformations before postnatal infection worsens the prognosis. In the majority of cases, there is a unilateral and moderate dilatation requiring a check-up only during the second week of life; treatment subsequently depends on the etiology of the uropathy and the consequences on the kidney. Unilateral severe dilatations and bilateral, but moderate, dilatations must be managed immediately after birth in a pediatric surgical center. In the rare cases of severe bilateral obstructive uropathy, in utero decompression by catheterisation or surgery is now considered to be uselessly invasive, considering that renal dysplasia is already present when the malformation is detected.
产前超声检查的主要益处在于能够在产后感染使预后恶化之前尽早诊断出泌尿系统畸形。在大多数情况下,存在单侧中度扩张,仅在出生后第二周进行检查即可;后续治疗取决于泌尿系统疾病的病因以及对肾脏的影响。单侧严重扩张和双侧但中度的扩张必须在出生后立即在小儿外科中心进行处理。在极少数严重双侧梗阻性泌尿系统疾病的病例中,考虑到在检测到畸形时肾发育不全已经存在,目前认为通过导管插入术或手术进行宫内减压具有不必要的侵入性。