Jee L D, Rickwood A M, Turnock R R
Regional Department of Paediatric Urology, Royal Liverpool Children's Hospital, Alder Hey.
Br J Urol. 1993 Nov;72(5 Pt 2):830-3. doi: 10.1111/j.1464-410x.1993.tb16277.x.
Forty-eight boys with posterior urethral valves were reviewed to assess the impact on prognosis of prenatal ultrasonography, which had been the method of diagnosis in 17 of them; the remaining 31 presented postnatally. Renal function before treatment was mildly to moderately impaired in 59% of those presenting prenatally, 42% presenting before 3 months of age and 25% of those first presenting when older than 3 months. All but one of the infants diagnosed prenatally had clinical signs and/or elevated serum creatinine in the early neonatal period. Eight had associated maternal oligohydramnios, of whom 6 presented prenatally and 2 postnatally: this factor was associated with a poor prognosis, with renal impairment persisting in 6 of these patients after treatment. Renal function did not relate consistently to the presence or otherwise of vesicoureteric reflux (unilateral or bilateral). Twelve of the patients who presented postnatally had normal fetal ultrasonography late in pregnancy, of whom 11 had upper tract dilatation when investigated. Six of these patients who currently have impaired renal function did not have maternal oligohydramnios, and it is argued that antenatal detection of the condition would have been beneficial in less than 20% of patients presenting postnatally with posterior urethral valves.
对48例患有后尿道瓣膜的男孩进行了回顾性研究，以评估产前超声检查对预后的影响，其中17例通过产前超声检查确诊；其余31例在出生后确诊。产前确诊的患儿中，59%在治疗前肾功能有轻度至中度损害；3个月龄前确诊的患儿中，这一比例为42%；3个月龄后首次确诊的患儿中，这一比例为25%。除1例产前确诊的婴儿外，所有患儿在新生儿早期均有临床症状和/或血清肌酐升高。8例患儿母亲有羊水过少，其中6例产前确诊，2例产后确诊：这一因素与预后不良相关，6例患儿治疗后肾功能仍有损害。肾功能与膀胱输尿管反流（单侧或双侧）的有无并无一致的关联。12例出生后确诊的患儿在妊娠晚期胎儿超声检查正常，其中11例在接受检查时有上尿路扩张。目前肾功能受损的6例患儿母亲无羊水过少情况，有人认为，对于出生后患有后尿道瓣膜的患儿，产前检测该疾病对不到20%的患儿有益。
