新生儿肾积水的评估与管理
Evaluation and management of hydronephrosis in the neonate.
作者信息
Oliveira Eduardo A, Oliveira Maria Christina L, Mak Robert H
机构信息
aPediatric Nephrourology Division, Department of Pediatrics, Faculty of Medicine, National Institute of Science and Technology (INCT) of Molecular Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil bDivision of Pediatric Nephrology, Rady Children's Hospital San Diego, University of California, San Diego, California, USA.
出版信息
Curr Opin Pediatr. 2016 Apr;28(2):195-201. doi: 10.1097/MOP.0000000000000321.
PURPOSE OF REVIEW
The prenatal detection of congenital anomalies of the kidney and urinary tract (CAKUT) has permitted the early management of these conditions. The aim of this review is to provide an overview of the management of neonates with antenatal hydronephrosis (ANH).
RECENT FINDINGS
In spite of the continuous advances in the understanding of the genetic basis, clinical course, and outcomes of CAKUT, there are still many controversies regarding the clinical significance, postnatal evaluation, and management of neonates with ANH. Mild ANH will often resolve spontaneously, whereas moderate to severe ANH is frequently associated with CAKUT.
SUMMARY
ANH is a surrogate marker of potential congenital renal anomalies, but usually cannot identify a specific disease. A multidisciplinary team approach is required to diagnose and treat these complex disorders. Currently nonsurgical management of CAKUT should be considered whenever possible for infants with ANH.
综述目的
先天性肾和尿路畸形（CAKUT）的产前检测使得这些疾病能够得到早期管理。本综述的目的是概述产前肾积水（ANH）新生儿的管理。
最新发现
尽管在对CAKUT的遗传基础、临床过程和结局的理解方面不断取得进展，但关于ANH新生儿的临床意义、产后评估和管理仍存在许多争议。轻度ANH通常会自发缓解，而中度至重度ANH常与CAKUT相关。
总结
ANH是潜在先天性肾脏异常的替代标志物，但通常无法识别特定疾病。需要多学科团队方法来诊断和治疗这些复杂疾病。目前，对于ANH婴儿，应尽可能考虑对CAKUT进行非手术管理。
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