中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
Chinese Journal of Perinatal Medicine
2015年
9期
683-686
,共4页
肾盂扩张%超声检查,产前%预后
腎盂擴張%超聲檢查,產前%預後
신우확장%초성검사,산전%예후
Pyelectasis%Ultrasonography,prenatal%Prognosis
目的 探讨产前超声诊断的不同程度胎儿单纯性肾盂扩张与妊娠结局的关系. 方法 对2004年3月至2014年7月于复旦大学附属妇产科医院产前超声筛查发现且分娩的109例单胎妊娠胎儿单纯性肾盂扩张者(任何孕周,产前超声筛查提示胎儿单侧或双侧肾盂前后经≥5 mm且未合并其他脏器结构畸形或染色体异常)随访至新生儿期,内容包括有无进行胎儿染色体检查、产前B超随访及新生儿病情转归等;并通过受试者工作特性曲线分析肾盂扩张程度预测预后不良的最佳临界点及产前随访警戒点. 结果 109例胎儿单纯性肾盂扩张者中,83例在妊娠期有自然缓解倾向,且其中71例新生儿肾盂正常.新生儿随访中,新生儿死亡2例,9例需要接受手术治疗,余98例肾盂正常或仅需随访观察.受试者工作特性曲线下面积为0.860(95％CI:0.860±1.96×0.112),产前超声筛查预测预后不良的最佳临界点为肾盂前后径≥11 mm(灵敏度为81.8％,特异度为83.7％),产前随访警戒点为肾盂前后径≥7 mm,灵敏度为100.0％,特异度为50.0％. 结论 单纯性肾盂扩张胎儿大多预后良好,对产前超声提示肾盂前后径≥7 mm者应加强妊娠期及新生儿期随访,而肾盂前后径≥11 mm者新生儿期预后不良可能性大.
目的 探討產前超聲診斷的不同程度胎兒單純性腎盂擴張與妊娠結跼的關繫. 方法 對2004年3月至2014年7月于複旦大學附屬婦產科醫院產前超聲篩查髮現且分娩的109例單胎妊娠胎兒單純性腎盂擴張者(任何孕週,產前超聲篩查提示胎兒單側或雙側腎盂前後經≥5 mm且未閤併其他髒器結構畸形或染色體異常)隨訪至新生兒期,內容包括有無進行胎兒染色體檢查、產前B超隨訪及新生兒病情轉歸等;併通過受試者工作特性麯線分析腎盂擴張程度預測預後不良的最佳臨界點及產前隨訪警戒點. 結果 109例胎兒單純性腎盂擴張者中,83例在妊娠期有自然緩解傾嚮,且其中71例新生兒腎盂正常.新生兒隨訪中,新生兒死亡2例,9例需要接受手術治療,餘98例腎盂正常或僅需隨訪觀察.受試者工作特性麯線下麵積為0.860(95％CI:0.860±1.96×0.112),產前超聲篩查預測預後不良的最佳臨界點為腎盂前後徑≥11 mm(靈敏度為81.8％,特異度為83.7％),產前隨訪警戒點為腎盂前後徑≥7 mm,靈敏度為100.0％,特異度為50.0％. 結論 單純性腎盂擴張胎兒大多預後良好,對產前超聲提示腎盂前後徑≥7 mm者應加彊妊娠期及新生兒期隨訪,而腎盂前後徑≥11 mm者新生兒期預後不良可能性大.
목적 탐토산전초성진단적불동정도태인단순성신우확장여임신결국적관계. 방법 대2004년3월지2014년7월우복단대학부속부산과의원산전초성사사발현차분면적109례단태임신태인단순성신우확장자(임하잉주,산전초성사사제시태인단측혹쌍측신우전후경≥5 mm차미합병기타장기결구기형혹염색체이상)수방지신생인기,내용포괄유무진행태인염색체검사、산전B초수방급신생인병정전귀등;병통과수시자공작특성곡선분석신우확장정도예측예후불량적최가림계점급산전수방경계점. 결과 109례태인단순성신우확장자중,83례재임신기유자연완해경향,차기중71례신생인신우정상.신생인수방중,신생인사망2례,9례수요접수수술치료,여98례신우정상혹부수수방관찰.수시자공작특성곡선하면적위0.860(95％CI:0.860±1.96×0.112),산전초성사사예측예후불량적최가림계점위신우전후경≥11 mm(령민도위81.8％,특이도위83.7％),산전수방경계점위신우전후경≥7 mm,령민도위100.0％,특이도위50.0％. 결론 단순성신우확장태인대다예후량호,대산전초성제시신우전후경≥7 mm자응가강임신기급신생인기수방,이신우전후경≥11 mm자신생인기예후불량가능성대.
Objective To investigate the prognosis of isolated fetal pyelectasis detected by ultrasound.Methods A total of 109 cases of isolated fetal pyelectasis (renal pelvis anteroposterior diameter ≥ 5 mm by ultrasound screening at any gestational age without structural or chromosome abnormalities) detected by prenatal ultrasound screening from March 2004 to July 2014 in Obstetrics & Gynecology Hospital of Fudan University,were delivered and followed up until neonatal period on chromosome examination,prenatal B ultrasound and outcome of neonates.Receiver operating characteristics curves were plotted and used to predict the optimal critical point of poor prognosis and the warning point of follow-up.Results Among the 109 cases,83 cases tended to have a natural recovery during pregnancy,71 of them had normal renal pelvis.Two of the neonates died,9 cases needed surgical treatment,and 98 cases had normal renal pelvis or need follow-up only.The area under the receiver operating characteristics curves was 0.860 (95％CI:0.860± 1.96 × 0.112).The optimal critical point of poor prognosis was determined at ≥ 11 mm in anteroposterior diameter with sensitivity 81.8％,and specificity 83.7％,and the warning point of prenatal follow-up was at ≥ 7 mm in anteroposterior diameter with sensitivity 100.0％ and specificity 50.0％.Conclusions The prognosis of isolated fetal pyelectasis is mostly good.The fetus with pyelectasis thicker than 7 mm should be followed-up closely during prenatal and neonatal period,and the fetus with pyelectasis thicker than 11 mm is likely to have poor prognosis in neonatal period.
