163例胎儿肾盂扩张的产前、产后超声观察

Prenatal and postnatal observation of 163 fetal pyelectasis by ultrasound

目的：探讨胎儿不同程度肾盂扩张的预后。方法：2004年7月～2006年1月南京大学医学院附属鼓楼医院产前诊断中心对在本院门诊定期产前检查及住院分娩的孕妇进行胎儿产前多参数超声筛查12902例,超声测量胎儿双侧肾盂宽度,对肾盂扩张≥5mm者,分组进行随访观察。结果：发现一侧或双侧肾盂扩张≥5mm的胎儿有226例,除58例失访,5例引产外,对163例241只肾脏在不同孕龄及出生后的孩子进行了随访。241只肾脏按肾盂扩张在5～10mm间209只（占86.72%）,在10～15mm间30只（占12.45%）,≥15mm者2只（占0.83%）分组观察,随访结局如下：137例214只肾盂在胎儿期或孩子出生后15个月内恢复正常,肾盂扩张〈5mm（占88.80%）：其中16例21只肾盂在胎儿期恢复至5mm以下（占8.71%）,121例193只肾盂在孩子出生后15个月内恢复至5mm以下（占80.09%）。20只肾盂扩张在5～10mm间（占8.30%）。4只肾盂扩张在10～15mm间（占1.66%）。3只肾盂扩张≥15mm（占1.24%）。结论：胎儿期肾盂扩张〈15mm者大多数转归良好。胎儿期肾盂扩张≥15mm,或肾盂扩张〈15mm,但输尿管扩张≥15mm者泌尿生殖道异常率增高。

Objective： To investigate the prognosis of different level of fetal pyelectasis.Methods： 12902 pregnant women who were accepted periodic prenatal examination and delivery in our hospital were detected by dopier color ultrasound from July 2004 to January 2006. We measured the width of bilateral renal pelvis,and followed up the fetuses with pyelectasis thicker than 5mm. Results：226 cases were found having unilateral or bilateral pyelectasis thicker than 5mm. Except 58 cases missed and 5 cases induced abortion, we followed up 163 cases（241 kidneys） in different gestational age and postnatal period. Among them, 209 kidneys （86.72%） were discovered pyelectasis between 5mm to 10mm.The pyelectasis of 30 kidneys（12.45%） was between 10mm to 15mm,and that of 2 kidneys（0.83%） was thicker than 15mm.Follow-up result is as follow：137 cases（214 kidneys） were recovered in normal in fetus period or postnatal 15 months.Their pyeleetasis was thinner than 5mm（88.80% ）. Among them, 16 cases（21 kidneys） were recovered in fetus perind（8.71% ）. 121 cases（ 193 kidneys） were ：recovered in postnatal 15 months（80.09%）.The rest 20 kidneys＇ pyelcetasis was between 5mm to 10mm（8.30%） .4 kidneys＇ pyelectasis was between 10mm to 15mm（1.66% ）,and 3 kidneys＇ pyeleetasis was thicker than 15mm（ 1.24 % ）. Conclusion： The fetuses with pyelectasis thinner than 15mm in fetal period were mostly recovered well.The fetuses with pyelectasis thicker than 15mm,or pyelectasis thinner than 15mm but uretereetasis thicker 15mm were related to high incidence rate of children genitourinary tract anomaly.