输尿管支架置入术治疗孕期输尿管结石50例临床分析

Ureteral Stent Placement for Ureteral Calculi during Pregnancy:An Analysis of 50 Cases

目的探讨输尿管支架置入术在治疗孕期输尿管结石中的应用价值。方法对50例输尿管支架置入术治疗的孕期输尿管结石患者的临床资料进行回顾性分析。50例患者均经辅助检查证实输尿管结石,同时合并肾绞痛,经药物保守治疗无效,其中右输尿管结石25例、左输尿管结石22例、双侧输尿管结石3例,31例位于输尿管中、上段,19例位于输尿管下段。结果 50例患者中37例表面麻醉后膀胱镜下置管成功;12例膀胱镜下置管失败,改用输尿管镜下置管成功;1例逆行置管失败后局部麻醉行经皮肾顺行置管成功。所有患者术中、术后均未出现先兆流产,术后肾绞痛得到明显缓解,肾积水情况均有不同程度减轻。术后复查48例提示输尿管支架位置好,1例输尿管支架上端位于输尿管上段,1例患者输尿管支架术后3d拔除尿管时滑脱,经重新置管后位置佳。结论输尿管支架置入术操作简单、疗效确切,是治疗孕期输尿管结石的一种安全可靠的治疗方法。

ABSTRACT:Objective To explorer the value of ureteral stent placement in the treatment of ure-teral calculi during pregnancy.Methods Clinical data of 50 patients who underwent ureteral stent placement for ureteral calculi during pregnancy were retrospectively analyzed.Auxiliary examina-tion confirmed that all patients had ureteral calculi complicated by renal colic and failed to respond to conservative drug treatment.Among the 50 patients,25 had right ureteral calculi,22 had left u-reteral calculi,3 had bilateral ureteral calculi,31 had middle/upper ureteral calculi,and 19 had lower ureteral calculi.Results Thirty-seven patients successfully underwent cystoscopic catheter-ization after topical anesthesia.Twelve patients underwent successful ureteroscopic catheterization after failed cystoscopic catheterization.One patient underwent successful percutaneous renal an-terograde catheterization under local anaesthesia after failed retrograde catheterization.After treatment,renal colic was relieved obviously and hydronephrosis was alleviated to varying degrees with no threatened abortion in all patients.Postoperative reexamination showed that ureteral stents were placed appropriately in 48 patients and were located in upper ureter in 1 patient.In ad-dition,ureteral stents fell out in 1 patient when urinary catheter was removed on postoperative day 3.However,ureteral stents were appropriately placed after recatheterization in this patient. Conclusion Ureteral stent placement is a simple,effective,safe and reliable treatment for ureteral calculi during pregnancy.