妊娠期输尿管结石合并肾绞痛的治疗

The treatment of ureteral calculus complicated with renal colic during gestation preiod

目的:探讨妊娠期输尿管结石合并肾绞痛的治疗方法。方法:选择妊娠期输尿管结石合并肾绞痛17例患者,均首先给予保守治疗,6例经保守治疗症状消失;11例因保守治疗效果不理想行膀胱镜下输尿管双J管置入术,2例无法置入继续选择保守治疗,1例局部麻醉下行经皮肾穿刺造瘘术。结果:所有肾绞痛患者症状均明显缓解,8例成功置入双J管中,1例带管期间结石排出,5例留置双J管至产褥期结束后药物结合体外冲击波碎石成功排石,2例排石失败患者均于产褥期结束后行输尿管镜下钬激光碎石术。6例保守治疗后症状消失,无一例发生意外妊娠终止。结论:膀胱镜下输尿管双J管置入术是处理妊娠期输尿管结石合并肾绞痛安全而有效手段之一。

Objective：To explore the treatment of ureteral calculus complicated with renal colic during gestation period. Methods：Seventeen patients with ureteral calculus complicated with renal colic during the gestation period were treated with conservative treatment at first. Six patients symptoms disappeared after conservative treatment. Eleven cases were additionally treated with the cystoscopic ureteral double-J stenting due to their unsatisfactory conservative effects,2 cases were continuously treated with conservative treatment and 1 case were treated with the percutaneous nephrostomy under local anesthesia. Results：All symptoms in patients with renal colic were improved. Among 8 cases treated with double-J stenting,the stone of 1 case was discharged during the stent implanting, the stones of 5 cases were discharged by drugs combined with Extracorporeal shock wave lithotripsy from the stent implanting to the end of puerperium,and the stones of 2 cases failed to discharge,then who were treated with Ureteroscopic-holmium laser lithotripsy at the end of the puerperium. No accidental pregnancy termination case were found. Conclusions：The treatment of ureteral calculus complicated with renal colic during gestation period with ureteral catheter stenting under cystoscope is a safe and effective method.