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目的利用超声对胎儿肾积水程度进行分级观察,并了解预后情况,避免不必要的终止妊娠。方法采用彩色多普勒超声对在本院定期检查的胎儿肾盂扩张情况观察测量,对扩张程度进行分级,发现胎儿肾盂扩张150例180只肾,孕龄16-40w,按肾盂前后径及初发时间进行分级(Ⅰ级-Ⅳ级),出生后按不同时间进行随访分析。结果 150例肾积水180只肾中Ⅰ级107只,56只肾在出生前消失,10只肾在出生后3天消失,其余均在出生6个内月消失;Ⅱ级42只肾均在6个月内消失;Ⅲ级21只,7只肾6个月内好转,1例2只肾出生后手术治疗;Ⅳ级10只,其中5例8只引产,1例2只肾出生后手术治疗。结论胎儿期肾积水多为生理性,肾积水的预后与初发时间有密切关系。
Objective To evaluate the grading of fetal hydronephrosis with ultrasound and to understand the prognosis and avoid unnecessary termination of pregnancy. Methods Color Doppler echocardiography in our hospital regularly check the fetal pelvis dilatation observed and measured the extent of expansion were found in 150 cases of fetal renal pelvis dilated 180 kidney, gestational age 16-40w, according to the anterior and posterior renal pelvis and the initial Time for grading (Ⅰ-Ⅳ grade), at birth after follow-up analysis at different times. Results Among the 150 cases of hydronephrosis, 107 of grade Ⅰ were found in 107 nephrons. 56 kidneys disappeared before birth, 10 kidneys disappeared 3 days after birth and the rest disappeared within 6 months of birth. Grade Ⅱ 42 kidneys were 6 cases in grade Ⅲ disappeared within 6 months, grade Ⅲ improved in 6 months, 1 case had 2 kidneys surgically treated, grade Ⅳ had 10 cases, of which 5 cases had 8 induced abortion and 1 case had 2 kidneys born after operation treatment. Conclusion Most of hydronephrosis in fetus is physiological. The prognosis of hydronephrosis is closely related to the initial time.