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[儿童期发现的肾脏发育异常的诊断与治疗变化]

[Diagnostic and therapeutic changes in renal developmental anomalies detected in childhood].

作者信息

Rubecz I, Kodela I, Gasztonyi V, Horváth K, Pintér A

出版信息

Orv Hetil. 1989 Jun 4;130(23):1219-24.

PMID:2660065
Abstract

The authors diagnosed 40 renal malformations during 2 years investigated and 2 years control period. On the basis of analysing their patients they came to the conclusion that after the introduction of intrauterine routine ultrasound examinations and screening of childhood risk group the number of recognised renal malformations increased significantly (32 in the investigated and only 8 in the control period). Furthermore the age of patients at the time of diagnosing shifted to the early postnatal period, and the number of patients diagnosed on the basis of the positive urinary investigations decreased significantly. But the intrauterine routine ultrasound investigation at presently applied examination system can consider only one-third of fetal renal malformations. And also an important fact that the increased number of considered patients came from the increasing of patients who have needed operation and did not increase the number of infants who have needed only conservative therapy. According to the small surgical complications they concluded that the risk of the early surgical intervention does not seem to be higher than in case of postponed ones. On the basis of clinical observation with childhood risk group arising the necessarity of the non invasive postnatal routine screening.

摘要

作者在2年的研究期和2年的对照期内诊断出40例肾脏畸形。在分析其患者的基础上,他们得出结论,在引入宫内常规超声检查和对儿童风险群体进行筛查后,已识别的肾脏畸形数量显著增加(研究期内为32例,对照期仅为8例)。此外,诊断时患者的年龄转移到出生后早期,基于尿液检查阳性诊断出的患者数量显著减少。但目前应用的检查系统进行的宫内常规超声检查仅能发现三分之一的胎儿肾脏畸形。还有一个重要事实是,被考虑的患者数量增加是因为需要手术的患者增多,而仅需要保守治疗的婴儿数量并未增加。根据轻微的手术并发症,他们得出结论,早期手术干预的风险似乎并不高于延期手术。基于对儿童风险群体的临床观察,提出了产后非侵入性常规筛查的必要性。

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