【摘要】：目的通過(guò)采用多參數(shù)超聲評(píng)分法對(duì)胎兒腎積水的分析,探討多參數(shù)超聲評(píng)分法相對(duì)于單一診斷標(biāo)準(zhǔn)在區(qū)分生理性和病理性腎積水中的優(yōu)勢(shì),探討多參數(shù)超聲評(píng)分法對(duì)診斷胎兒腎積水的臨床意義。材料與方法1.研究對(duì)象:選取2011年1月至2013年12月在泰山醫(yī)學(xué)院附屬聊城市第二人民醫(yī)院行常規(guī)產(chǎn)前超聲檢查的單胎、晚孕期(≥28周)孕婦,腎盂前后徑≥10mm者納為研究對(duì)象。符合研究者共計(jì)53例,共66只腎臟,其中雙腎積水13例。根據(jù)產(chǎn)后隨訪的結(jié)果,把胎兒腎積水分為生理性腎積水和病理性腎積水兩組。2.研究方法:超聲評(píng)分參數(shù)包括腎盂前后徑(PAPD)、腎盂腎盞形態(tài)(PM)、腎實(shí)質(zhì)厚度(RPT)和腎動(dòng)脈阻力指數(shù)(RI)。對(duì)胎兒行常規(guī)超聲檢查并對(duì)各項(xiàng)參數(shù)進(jìn)行記錄。每隔3周復(fù)查一次,并記錄各項(xiàng)參數(shù)的變化情況。將4項(xiàng)參數(shù)按照積水程度由輕到重的順序進(jìn)行超聲評(píng)分(0-3分),并把各個(gè)分值相加得到每只腎臟的超聲總評(píng)分。3.統(tǒng)計(jì)學(xué)分析:對(duì)生理性和病理性腎積水的腎盂前后徑、腎盂腎盞形態(tài)、腎實(shí)質(zhì)厚度、腎動(dòng)脈阻力指數(shù)和超聲總評(píng)分進(jìn)行綜合分析研究,計(jì)算各自的靈敏度、特異度、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值及約登指數(shù),從而判定區(qū)分生理性腎積水與病理性腎積水的最佳方法。結(jié)果1.53例66只腎積水中,生理性腎積水46只,占腎積水總數(shù)的69.7%,病理性腎積水20只,占腎積水總數(shù)的30.3%。2.超聲評(píng)分為1、2、3、4分時(shí)全部為生理性腎積水,超聲評(píng)分為10、11、12分時(shí)全部為病理性腎積水,超聲評(píng)分為5、6、7、8、9分時(shí),病理性腎積水所占的比例分別為:16.7%、25.0%、33.3%、50.0%、75.0%。其最佳截?cái)嘀禐?分,約登指數(shù)為0.7913,即超聲評(píng)分≥7分時(shí)診斷為病理性腎積水,超聲評(píng)分7分時(shí)診斷為生理性腎積水的診斷率最高。3.以腎盂前后徑、腎盂腎盞形態(tài)、腎實(shí)質(zhì)厚度、腎動(dòng)脈阻力指數(shù)的最佳截?cái)嘀祦?lái)鑒別診斷生理性腎積水和病理性腎積水的約登指數(shù)分別為:0.6261、0.6761、0.7478、0.6978,均小于多參數(shù)超聲評(píng)分法。結(jié)論多參數(shù)超聲評(píng)分法在診斷胎兒腎積水中有優(yōu)勢(shì),利于鑒別生理性和病理性腎積水,從而為胎兒腎積水的臨床治療提供正確依據(jù),值得在臨床推廣應(yīng)用。
[Abstract]:Objective to analyze fetal hydronephrosis by using multi-parameter ultrasonic scoring method, and to explore the advantages of multi-parameter ultrasound scoring method in distinguishing physiologic hydronephrosis from pathological hydronephrosis. To investigate the clinical significance of multi-parameter ultrasonic scoring in the diagnosis of fetal hydronephrosis. Materials and methods 1. Participants: from January 2011 to December 2013, single pregnancy with routine prenatal ultrasound examination was performed in Liaocheng second people's Hospital affiliated to Taishan Medical College. Pregnant women with late pregnancy (鈮，

本文編號(hào)：2211455