两种腔镜术式治疗妊娠合并输尿管结石的比较

Comparision between two transurethral operations in treating pregnant women with ureteral calculi

目的比较放置双J管及输尿管镜碎石术治疗妊娠合并输尿管结石患者的临床疗效和安全性。方法回顾性分析解放军第11医院2009年3月至2014年5月行经尿道手术治疗的59例妊娠合并输尿管结石患者的临床资料。31例患者接受膀胱镜下双J管置入术（组Ⅰ）;28例患者行输尿管镜碎石术（组Ⅱ）。比较两组手术时间、手术成功率和术后住院时间等指标并记录不良事件发生情况。结果 59例患者肾绞痛症状均缓解,均足月顺利分娩,没有严重不良事件发生。组Ⅰ手术成功率96.8%（30/31）,组Ⅱ为92.9%（26/28）,两者差异无统计学意义（P=0.928）。组Ⅰ手术时间为9~43 min,平均（23±8）min,组Ⅱ手术时间为19~52 min,平均（31±9）min,两者差异有统计学意义（P〈0.001）。组Ⅰ术后住院时间为2~9 d,平均（4±2）d,组Ⅱ为1~5 d,平均（3±1）d,两者差异有统计学意义（P=0.040）。结论膀胱镜下放置双J管和输尿管镜碎石术治疗保守疗法无效的妊娠合并输尿管结石患者均安全、有效。

Objective To investigate the efficacy and safety of placing double-J ureteral stents and ureteroscopic lithotripsy in treatment of pregnant women with ureteral calculi.Methods A total of 59 pregnant women with ureteral calculi who underwent transurethral operations in our hospital from March2009 to May 2014 were enrolled into two groups.In group Ⅰ,31 cases underwent placing double-J ureteral stents under cystoscope.In group Ⅱ,28 cases underwent ureteroscopic lithotripsy.Operation time,the successful rate of operation and hospital stay after operation in both groups were compared.Adverse effects were recorded.Results Of all the 59 cases,renal colic was relieved by operations.All the women experienced full-term pregnancy successfully.No severe adverse event occurred.The successful rate of operation was 96.8%（30/31） in group Ⅰ and 92.9%（26/28） in group Ⅱ（P=0.928）.The operation time was[9-43,（23±8）] min in group Ⅰand [19-52,（31±9）] min in group Ⅱ（P〈0.001）.The hospital stay after operation was [2-9,（4±2）] days in group Ⅰ and [1-5,（3±1）] days in group Ⅱ（P=0.040）.Conclusion Placing double-J ureteral stents under cystoscope and ureteroscopic lithotripsy are safe and efficient for the treatment of pregnant women with ureteral calculi whose renal colic cannot be alleviated by conservative methods.