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目的:研究同期收治的一组出生前、一组出生后诊断的先天性肾积水患儿,手术后随访评价其产前诊断早期治疗的优越性与必要性。方法:根据症状、B 超、静脉尿路造影、核素及我院肾病研究所制定的肾功能综合评价标准,对两组共44例的术后随访进行对照研究。结果:9例出生前诊断患儿中平均手术年龄72天,随访率100%,除1例双侧巨大肾积水患几合并一侧肾下盏小结石外,余均正常。35例出生后诊断组平均手术年龄5岁,随访率65.7%;受检者核素动静态扫描全部异常;均有不同程度酸中毒;肾小管功能五项指标均呈阳性反应。结论:在同期不等数的病例对照的随访研究中,均可证实先天性肾积水的产前诊断及出生后早期手术的可行性、优越性、重要性。产前诊断值得推广。
OBJECTIVE: To study a group of children with congenital hydronephrosis diagnosed by birth before birth who were treated at the same period. Postoperative follow-up evaluation of the advantages and necessity of prenatal diagnosis of early treatment. Methods: According to the symptoms, B-ultrasonography, intravenous urography, radionuclide and our hospital kidney disease developed by the comprehensive evaluation of renal function criteria, the two groups of 44 cases were followed up for a controlled study. Results: The mean age at diagnosis of 9 children born before birth was 72 days. The follow-up rate was 100%. Except for 1 case of bilateral giant hydronephrosis with multiple small kidney stones, all were normal. 35 cases of post-natal diagnosis group average operation age of 5 years, the follow-up rate of 65.7%; subjects were all abnormal dynamic and static scans; both have varying degrees of acidosis; renal tubular function of five indicators were positive. CONCLUSION: In the follow-up study of unequal number of cases in the same period, the feasibility, superiority and importance of prenatal diagnosis of congenital hydronephrosis and early postnatal surgery were confirmed. Prenatal diagnosis is worth promoting.