超声评分法及肾动脉阻力指数对胎儿肾积水预后的研究价值.pdfVIP

·824 · 临床超声医学杂 ·临床研究· 超声评分法及肾动脉阻力指数对胎儿肾积水 预后的研究价值 王婧霖 刘雨函 吕 卓 摘 要 目的 探讨超声评分法及肾动脉阻力指数（RI）对评价胎儿肾积水预后的价值。方法 晚孕期136例肾 积水胎儿，测定其肾盂前后径（APD）、肾实质厚度、肾盂肾盏形态并分别赋予0～3分，累计其分值；胎儿超声检查时测定 每个积水肾脏肾门处肾动脉的RI值。以上结果与出生后的超声检查及临床诊断对照。结果 超声评分≤3、4、5、6、7 及≥8分的胎儿，其病理性肾积水者所占比例为0、17.6%、33.3%、55.5%、81.8%及100%。以综合评分5分为诊断胎儿病理 性肾积水的最佳截断值，其灵敏度、特异度分别为94.0%、87.9%。超声评分≤ 5分的肾积水患儿，肾动脉RI的数值范围为 0.62~0.68，而5分的肾积水患儿，肾动脉RI范围为0.70~0.79。结论 超声评分法及肾血管RI对胎儿肾积水预后的评 价都有较高的指导实用价值。 关键词 超声检查；胎儿；超声评分法；阻力指数，肾血管 ［中图法分类号］ ； ［文献标识码］ R445.1 R692.2 A Research value of ultrasonic evaluation method and renal vascular index for prognosis in fetal with hydronephrosis WANG Jinglin ，LIU Yuhan ，LV Zhuo Department of Ultrasound ，Siping Hospital of China Medical University ，Jilin 136000 ，China ABSTRACT Objective To explore the value of evaluating prognosis in fetal with hydronephrosis using ultrasonic evaluation method and renal vascular resistance index.Methods The renal pelvis anteroposterior diameter ，renal parenchyma thickness ，morphology of renal pelvis and calyces in 136 fetus with hydronephrosis during late pregnancy were measured and scored from 0 to 3 points ，and cumulative scores were calculated.Resistance index （RI）of renal artery in renal hilus of hydrops kidney was measured using fetus ultrasonography.The above results were compared with clinical diagnosis and ultrasonography after birth.Results Pathological hydronephrosis accounted for the proportions of 0 ，17.6% ，33.3% ，55.5% ，81.8% and 100% ， respectively ，according to ultrasonic score