妊娠合并上尿路结石致肾绞痛的临床诊治策略

Clinical Treatment Strategy for Renal Colic in Pregnant Women with Upper Urinary Tract Stones:A Report of103 Cases

目的:探讨妊娠期上尿路结石致肾绞痛的诊断和治疗方法。方法:对103例妊娠期上尿路结石致肾绞痛患者的临床资料及诊治过程进行分析,结合文献讨论本病的临床特点及诊治方法。结果:92例B型超声检查发现结石,11例仅发现患侧肾脏积水。所有患者均先行保守治疗;期间14例行输尿管置管术,7例行输尿管镜下气压弹道碎石术,2例行经皮肾穿刺造瘘术;101例患者顺利足月分娩;2例终止妊娠,孕妇平安。结论:妊娠期上尿路结石的诊断首选超声检查。对于有症状发作者保守治疗是主要治疗方法,治疗用药物应注意保护胎儿。对于顽固性肾绞痛患者,外科治疗首选逆行插管引流尿液,必要时可选择输尿管镜检查或经皮肾穿刺。开放手术为最后的治疗手段。

Objective：To explore the diagnosis and treatment of the upper urinary tract calculi caused renal colic in pregnant woman.Methods：Totally 103 pregnant women complicating with upper urinary tract calculi were analyzed.Results：All patients were diagnosed with Type B ultrasonography.All patients underwent medicine therapy preliminary.Following with 14 cases underwent double J stents,7 cases underwent transureteroscopic lithotripsy,and 2 cases underwent percutaneous nephrostomy.101 cases experienced full term pregnancy and 2 cases were abortion.Conclusion：For the pregnant women complicating with upper urinary tract calculi,ultrasound is the preliminary consideration.The percutaneous nephrostomy,urteroscopy,and even the double J stents inserting were safety choices.