CAJ | 학술논문

目的：观察产前超声诊断先天性肾盂积水肾盂前后径（anteroposterior renal pelvic diame-ter，APD）等数值的变化规律，探讨APD等相关数据在判断生理性或病理性肾盂积水中的临床价值。方法随访观察2011年4月至2013年2月69例行产前超声检查诊断为胎儿先天性肾盂积水患儿的临床资料，根据发展趋势分为生理性肾盂积水和病理性肾盂积水，并对两组积水APD值等相关数据进行比较分析。结果69例（73只肾）中，生理性肾盂积水55例（57只肾），积水多在产后1～6个月消失。病理性肾盂积水14例（16只肾），其中肾盂输尿管部梗阻12例（14只肾），膀胱输尿管部梗阻2例，未发现其它泌尿系统畸形。两组积水在胎儿性别、积水侧别、积水发生时间及孕30～33周前APD、肾皮质厚度（renal parenchyma thickness，RPT）、肾盏形态上比较，P＞0．05，差异无统计学意义。在孕30～33周及孕30～33周后APD、RPT、肾盏形态上比较，P＜0．05，差异有统计学意义。结论胎儿先天性肾盂积水最终发展趋势与胎儿性别、积水侧别、积水发生时间及孕30～33周前APD、RPT、肾盏形态无相关性；与孕30～33周及孕30～33周后APD、RPT、肾盏形态有相关性。在定期随访过程中，生理性肾盂积水多于产后1～6个月恢复正常，病理性肾盂积水的各项指标呈渐进性发展，需及时手术治疗。
목적：관찰산전초성진단선천성신우적수신우전후경（anteroposterior renal pelvic diame-ter，APD）등수치적변화규률，탐토APD등상관수거재판단생이성혹병이성신우적수중적림상개치。방법수방관찰2011년4월지2013년2월69례행산전초성검사진단위태인선천성신우적수환인적림상자료，근거발전추세분위생이성신우적수화병이성신우적수，병대량조적수APD치등상관수거진행비교분석。결과69례（73지신）중，생이성신우적수55례（57지신），적수다재산후1～6개월소실。병이성신우적수14례（16지신），기중신우수뇨관부경조12례（14지신），방광수뇨관부경조2례，미발현기타비뇨계통기형。량조적수재태인성별、적수측별、적수발생시간급잉30～33주전APD、신피질후도（renal parenchyma thickness，RPT）、신잔형태상비교，P＞0．05，차이무통계학의의。재잉30～33주급잉30～33주후APD、RPT、신잔형태상비교，P＜0．05，차이유통계학의의。결론태인선천성신우적수최종발전추세여태인성별、적수측별、적수발생시간급잉30～33주전APD、RPT、신잔형태무상관성；여잉30～33주급잉30～33주후APD、RPT、신잔형태유상관성。재정기수방과정중，생이성신우적수다우산후1～6개월회복정상，병이성신우적수적각항지표정점진성발전，수급시수술치료。
Objetive To observe the numerical value change rule of anteroposterior renal pelvic diame-ter(APD)et al in prenatal ultrasound diagnosis of congenital hydronephrosis,estimate the clinical value of rele-vant data of APD etc in judgment of the physiologic or pathologic hydronephrosis. Methods From April 201 1 to February 2013,69 cases of fetal congenital hydronephrosis were diagnosed by prenatal ultrasound,all the ca-ses were underwent a follow-up visit.According to their development tendency,the congenital hydronephrosis were distinguished into physiological hydronephrosis and pathological hydronephrosis.The relevant data of APD values of the two groups were followed a comparative analysis. Results In 69 cases of hydronephrosis (73 kid-neys),55 cases (57 kidneys)suffered from physiological hydronephrosis and their hydronephrosis disappeared in 1 ~6 months postpartum;14 cases (16 kidneys)suffered from pathological hydronephrosis,among which 12 patients (14 kidneys)had ureteropelvic junction obstruction and 2 cases had vesicoureteral junction obstruc-tion,other urinary tract malformation was not found.Two groups of hydronephrosis have no statistical signifi-cances in fetal gender,the side of hydronephrosis,the time of occurrence and in the APD,renal parenchyma thickness(RPT),calyx shape before 30~33 weeks of pregnancy (P>0.05).And in or after 30~33 weeks of pregnancy have a statistical significances in APD,renal parenchyma thickness(RPT),calyx shape (P<0.05 ). Conclusion There is no correlation between the ultimate development trends of congenital fetal hydronephrosis with the fetal gender,the side of hydronephrosis,the time of occurrence and the APD、RPT、calyx shape before 30~33 weeks of pregnancy.But in or after 30~33 weeks of pregnancy there is correlation with APD、RPT,ca-lyx shape In the regular follow-up visit,the physiological hydronephrosis indicates still volatile in 38~40 weeks of pregnancy,and most return to normal in 1 ~6 months postpartum.Pathological hydronephrosis indicates grad-uallyincreasing,requires timely surgical treatment.