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胎儿肾盂集合系统的扩张、胎儿肾积水是产前超声检查可发现的常见胎儿异常表现之一,发生率约为1%～5%。生理性肾积水可在出生后自行缓解,而病理性肾积水则会继续恶化,甚至导致肾功能受损。产前检查区分胎儿肾积水的原因报道较少。多数胎儿肾积水分级以肾盂前后径值为标准,有的同时结合其他超声表现,如肾盏扩张、肾脏回声、肾实质变薄、膀胱扩张及羊水量等。目前对胎儿肾积水的诊断和分级尚无统一的标准。综述一些超声检查新指标,为临床处理胎儿肾积水提供循证医学依据。
Fetal renal pelvis system expansion, fetal hydronephrosis is a prenatal ultrasound can be found in common fetal abnormalities, one of the incidence of about 1% to 5%. Physiological hydronephrosis can be relieved after birth, and pathological hydronephrosis will continue to deteriorate, and even lead to impaired renal function. Prenatal examination to distinguish the cause of fetal hydronephrosis less reported. Most fetal hydronephrosis grading the anteroposterior diameter of the renal pelvis as the standard, while others with other ultrasound manifestations, such as calyx expansion, renal echo, thinning of the renal parenchyma, bladder expansion and amniotic fluid volume. Currently there is no uniform standard for the diagnosis and grading of fetal hydronephrosis. To summarize some new indexes of ultrasound examination and provide evidence-based medicine for clinical treatment of fetal hydronephrosis.