Preston A, Lebowitz R L
Department of Radiology, Children's Hospital, Boston, Massachusetts 02115.
Urol Radiol. 1989;11(4):217-20. doi: 10.1007/BF02926519.
The diagnosis and treatment of infants and children with urinary tract abnormalities have recently been affected by three developments. First, hydronephrosis can be detected in the fetus on obstetrical ultrasonography. Prenatal detection has resulted in a marked increase in the number of neonates referred for uroradiologic evaluation. Ureteropelvic junction (UPJ) obstruction, ureterovesical junction obstruction (UVJ), and reflux have been found to be the most common causes of hydronephrosis. Prophylactic antibiotics begun soon after delivery can prevent infection and its sequelae. Second, multicystic dysplastic kidney can now be accurately diagnosed preoperatively by a combination of ultrasonography and renal scintigraphy. This diagnostic certainty makes the decision to remove such a kidney a philosophical one. Third, it has been learned that reflux is sometimes familial. Nuclear cystography is an accurate and efficient method for screening asymptomatic family members.
近期，三项进展对婴幼儿尿路异常的诊断和治疗产生了影响。其一，产科超声检查可在胎儿期检测出肾积水。产前检测导致转诊接受尿放射学评估的新生儿数量显著增加。肾盂输尿管连接部（UPJ）梗阻、输尿管膀胱连接部梗阻（UVJ）和反流被发现是肾积水最常见的病因。出生后不久开始使用预防性抗生素可预防感染及其后遗症。其二，多囊性发育不良肾现在可通过超声检查和肾闪烁显像相结合的方法在术前准确诊断。这种诊断的确定性使得决定切除这样的肾脏成为一个需要慎重考虑的问题。其三，人们已经了解到反流有时具有家族性。核素膀胱造影是筛查无症状家庭成员的一种准确且有效的方法。
