Vemulakonda Vijaya, Yiee Jenny, Wilcox Duncan T
Department of Pediatric Urology, Children's Hospital Colorado, 13123 East 16th Avenue, Campus Box B-463, Aurora, CO, 80045, USA,
Curr Urol Rep. 2014 Aug;15(8):430. doi: 10.1007/s11934-014-0430-5.
Congenital hydronephrosis is one of the most common anomalies identified on antenatal ultrasound. The underlying etiology of congenital hydronephrosis is multifold, ranging from transient hydronephrosis in utero to clinically significant congenital anomalies of the kidney and urinary tract. While traditional management of hydronephrosis was aimed at relieving symptoms, the advent of routine prenatal ultrasound has led to a shift in the goal of treatment to prevention of renal injury in the asymptomatic patient. However, despite this focus on renal preservation, the diagnostic criteria for identification of children "at risk" for renal damage that can be alleviated by surgical treatment remain a subject of debate. Both antenatal and postnatal imaging studies have been evaluated as indicators for potential reversible renal damage and have been used as potential indicators of the need for surgical intervention. The aim of this review is to discuss the current literature regarding the role of postnatal clinical and radiographic evaluation to identify children who may benefit from early surgical intervention.
先天性肾积水是产前超声检查中最常见的异常情况之一。先天性肾积水的潜在病因是多方面的，从子宫内的短暂性肾积水到具有临床意义的肾脏和泌尿系统先天性异常。虽然传统的肾积水治疗旨在缓解症状，但常规产前超声的出现导致治疗目标转向对无症状患者预防肾损伤。然而，尽管重点在于肾脏保护，但用于识别可通过手术治疗缓解肾损伤 “风险” 儿童的诊断标准仍是一个有争议的话题。产前和产后影像学检查均已作为潜在可逆性肾损伤的指标进行评估，并已被用作手术干预必要性的潜在指标。本综述的目的是讨论当前关于产后临床和影像学评估在识别可能从早期手术干预中获益儿童方面作用的文献。
