宫内干预治疗胎儿尿路梗阻的疗效

M. Pavlichenko, N. Kosovtsova, N. Bashmakova
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摘要

引言:新生儿出生后不久发生的慢性肾功能衰竭的主要原因是阻塞性尿路病。目的:根据对该手术围产期结果的评估,以及对“Cook”(爱尔兰)制造的3.0 Fr/100 mm支架和“SDE–MED”3.0 Fr/50 mm辫子原始形状支架的使用进行比较分析,证明肾羊膜分流的有效性。方法:在动物实验中,对FGBU母婴保健研究所研制的“SDE-MED”3.0Fr/50mm辫子原始形状支架的安全性进行检查后,将该支架应用于临床,用于单侧或双侧Ⅲ~Ⅳ级肾积水和后尿道瓣膜病患者的宫内分流。在研究的最后一部分,对使用两种不同支架的肾羊膜分流的结果进行了比较。结果:与“Cook”(爱尔兰)制造的3.0 Fr/100 mm支架相比,“SDE–MED”3.0 Fr/50 mm支架在胎儿肾腔系统中提供了更有效的固定。结论:上尿路宫内分流术是治疗尿路梗阻的一种病因合理的方法,可用于纠正各种类型的胎儿肾梗阻。
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Outcomes of intrauterine interventions for the treatment in fetal urinary tract obstructions
Introduction: The leading cause of chronic renal failure in newborns, which occurs soon after birth is obstructive uropathies. Objectives: To prove the effectiveness of nephroamniotic shunting based on the evaluation of perinatal outcomes of this procedure, as well as a comparative analysis of the use of the stent manufactured by "Cook" (Ireland), 3.0 Fr/100 mm and the stent “SDE–MED”, 3.0 Fr/50 mm with the original shape of pigtails. Methods: After checking the safety of the stent “SDE-MED”, 3.0 Fr/50 mm developed by FGBU Mother and Child Care Research Institute with the original shape of pigtails in an animal experiment, the stent was used in clinical practice for intrauterine shunting in cases of unilateral or bilateral hydronephrosis of grade III to IV and posterior urethral valve disorder. In the final part of the study, a comparison of the outcomes of nephroamniotic shunting using two different stents was made. Results: The “SDE–MED” 3.0 Fr/50 mm stent provided more effective fixation in the fetal kidney cavity system in comparison to the stent manufactured by “Cook” (Ireland) 3.0 Fr/100 mm. Conclusion: Intrauterine shunting surgery of the upper urinary tract is a pathogenetically justified method of treating urinary tract obstructions and can be used to correct all types of fetal renal obstructions.
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