妊娠合并上尿路结石急症的急诊处理

Treatment of Acute Disease of upper Urinary Tract Calculus with Pregnancy Women

目的:探讨妊娠合并上尿路结石急症安全有效的急诊临床处理方法。方法:妊娠合并上尿路结石急症患者21例,其中采用膀胱镜下双J管置入13例,经输尿管镜下双J管置入1例,输尿管镜下取石2例,B超引导下经皮肾穿刺造瘘3例,开放手术2例。结果:21例临床症状缓解。19例均顺利渡过围产期,并产健康婴儿;1例B超引导下经皮肾穿刺造瘘术后感染控制不满意,后终止妊娠;1例开放手术后出现并发症终止妊娠。结论:膀胱镜下双J管置入在妊娠合并上尿路结石急症患者急诊处理中安全有效,且应为首选。

Objective： To find a safe and effective way in treatment of upper urinary tract calculus in pregnant women. Methods： 21 pregnant women with upper urinary tract calculus were employed. 13 of them accepted the indwelling of double J tube under cystoseope, one case was indwelled the double J tube under ureteroscope, 2 cases accepted the stone exclusion under ureteroseope, 3 accepted percutaneous renal puncture for urine drainage with the help of Ultrasonic, and 2 accepted an operation. Results： Pain relief took place in all of the 21 patients, and 19 of them got a successful pregnancy. However, pregnancy had to be stopped for two patients. One of them accepted a percutaneous renal puncture and the other accepted an operation because of infection. Conclusions： indwelling double J tube under cystoscope is safe and effective to the pregnant women with upper urinary tract calculus, and thus should be the first choice of these patients.