胎儿肾积水(antenatal hydronephrosis,AHN)是产前超声筛查中最常见的先天性肾脏和尿路畸形(congenital anomalies of kidney and urinary tract,CAKUT).约 2/3 的 AHN 为生理性,生后往往可自愈,部分患儿肾积水进行性加重,可能出现肾功能受损或严重并发症,需要手术干预.目前针对AHN患儿的产前及出生后管理认识不一,如何对患儿进行风险分层并制定合理的随访计划尤为重要.该文对AHN患儿产前及出生后的临床评估及管理等进行综述,以提高高风险患儿家庭对AHN的重视,并减轻低风险患儿家庭的焦虑和过度干预,促进个体化诊疗.
Progress on prenatal and postnatal evaluation and management of antenatal hydronephrosis
Antenatal hydronephrosis(AHN)is the most common congenital anomalies of kidney and urinary tract(CAKUT)detected through prenatal ultrasound screening.Approximately two-thirds of AHN are physiological and can be relieved spontaneously after birth,while AHN may be aggravated in some cases,resulting in deterioration of kidney function or severe complications and requiring surgical intervention.Currently,there is a lack of consensus on the prenatal and postnatal management of AHN,making it crucial to stratify the risk for affected children and establish appropriate follow-up plans.This article reviews the clinical assessment and management of AHN in prenatal and postnatal settings based on domestic and international literature,with the goal of raising AHN awareness among families of high-risk children and alleviating anxiety and excessive intervention for families of low-risk children,ultimately promoting individualized diagnosis and treatment.
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