新生儿肾静脉血栓形成:治疗及远期预后。

Annales de pediatrie Pub Date : 1993-02-01
P Brun, F Beaufils, G Pillion, N Schlegel, C Loirat
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引用次数: 0

摘要

对我院1973 ~ 1991年诊断为肾静脉血栓的新生儿39例进行回顾性分析。25例患者接受尿激酶治疗,14例未接受尿激酶治疗(UK)。在5例死亡(13%)中,4例发生在急性期非肾并发症,1例发生在终末期肾功能衰竭3个月大时。8例患者(21%)在平均7.4年的随访后出现中度肾功能衰竭;1例患者(2%)在7.9年后发展为终末期肾衰竭,25例患者(64%)在平均随访4.5年后肾小球滤过率正常。服用UK组的死亡率和慢性肾衰竭率分别为8%和32%,未服用UK组的死亡率和慢性肾衰竭率分别为21%和7%。54个受累肾脏中,只有10个(19%)恢复了正常的功能和形态特征。37个接受UK治疗的肾脏中有11个(30%)出现功能障碍,17个未接受UK治疗的肾脏中有10个(59%)出现功能障碍。虽然这些数据表明UK可能对促进血栓阻塞的肾静脉再通有效,但只有通过进行前瞻性治疗试验才能获得确证证据。
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[Thrombosis of the renal veins in the newborn: treatment and long term prognosis].

Thirty-nine neonates with renal vein thrombosis diagnosed in our hospital department between 1973 and 1991 were studied retrospectively. Twenty-five patients were and 14 were not treated with urokinase (UK). Among the five deaths (13%), four occurred at the acute stage from non-renal complications and one occurred at the age of three months from end-stage renal failure. Eight patients (21%) have moderate renal failure after a mean follow-up of 7.4 years; a single patient (2%) developed end-stage renal failure after 7.9 years and 25 patients (64%) have a normal glomerular filtration rate after a mean follow-up of 4.5 years. Rates of death and chronic renal failure were 8% and 32%, respectively, in the group given UK and 21% and 7%, respectively, in the group not given UK. Among 54 involved kidneys, only 10 (19%) recovered normal function and morphological features. Functional impairment was seen in 11 of 37 (30%) kidneys treated by UK and 10 of 17 (59%) kidneys not treated by UK. Although these data suggest that UK may be effective in promoting recanalization of renal veins obstructed by thrombosis, confirmatory evidence could be obtained only by performing a prospective therapeutic trial.

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