泌尿系统先天畸形患儿预后危险因素的研究

Risk factors of mortality in newborns with congenital abnormalities of urinary system

目的探讨影响泌尿系统先天畸形患儿预后的危险因素。方法 2004～2011年住院新生儿中148例泌尿系统先天畸形患儿,主要的预后指标是新生儿死亡率,危险因素包括:母亲年龄、首次妊娠、早产儿、低体重、羊水过少、小儿泌尿系统先天畸形等。结果 148例泌尿系统先天畸形患儿,尿道扩张92例,肾囊肿性疾病22例,其他34例。尿道扩张组独立危险因素是泌尿系统先天畸形、早产、低体重、羊水过少及合并肾脏畸形。肾囊肿性疾病组独立危险因素是羊水过少、低体重和复合型泌尿系统先天畸形。结论肾外异常是泌尿系统先天畸形患儿预后差的预测指标之一。

Objective To explore predictive factors of mortality in newborns with congenital abnormalities of urinary system. Methods 148 patients were studied.The main prognosis was neonatal mortality.Risk factors were maternal age,first pregnancy,low birth weight,prematurity,oligohydramnios and congenital abnormalities of urinary system associated with other malformations. Results Congenital abnormalities of urinary system was detected in 148 newborns.92 cases were classified as urinary tract dilatation,22 as renal cystic disease,and 34 as other subgroups.In the urinary tract dilatation subgroup,independent risk factors for early mortality were associated with congenital abnormalities of urinary system,prema turity,LBW,oligohydramnios and renal abnormality .In the renal cystic disease subgroup,risk factors were oligohydramnios, LBW and associated with congenital abnormalities of urinary system. Conclusion Extrarenal abnormalities was a strong predictor of poor outcome in infants with congenital abnormalities of urinary system.