超声诊断胎儿泌尿系畸形的探讨

An exploration of diagnostic ultrasonography on fetal genitourinary system malformation

目的 探讨超声诊断胎儿泌尿系畸形的声像图特征和临床实用价值。方法 按产科超声常规检查胎儿。结果 本组27例胎儿泌尿系畸形,超声检测28孕周前诊断9例,28孕周后诊断18例。单肾3例、单侧肾发育不良1例、重复肾1例、肾积水8例、多囊肾12例、输尿管下段狭窄及尿道闭锁、巨膀胱各1例。合并脑积水1例、膈疝1例。全部病例经引产后尸解证实12例,出生后手术证实1例,IVP及超声随访复查证实14例。 结论 前超声诊断胎儿泌尿系畸形,对胎儿预后判断、临床及早采取措施提供诊断依据,这对优生优育、对新生儿早期治疗有重要临床实用价值。

Objective To explore the sonography characteristics and clinical value of fetal genitourinary system malformation. Methods All referred fetus were accepted routine obstetrics B-mode ultrasonographic scan. Results Totally 27 cases of fetal genitourinary system malformation were enrolled in this group, in which 9 cases were diagnosed before gestation 28 weeks and 18 cases screened after 28 weeks. The genitourinary abnormalities cases were described as following: single kidney(3), unilateral kidney development deficiency(1), duplicate kidney (1), hydronephrosis(8), lower part of urethra obstruction(1), urethral atria(1)and polycystic kidney disease(12). One case complicated with hy-drocephalus and another case with diaphragmatic hernia. Twelve cases were confirmed by autopsy. One case was confirmed after birth, and 14 cases were confirmed by IVP and sonography follw up. Conclusion Fetal genitourinary system malformation screened by prenatal sonography aids to fetal prognosis judgement and medical intervening, as well as improves birth quality.