双J管置入术治疗妊娠期急性梗阻性肾盂肾炎疗效分析

Clinical efficacy of insertion of double J tube in treatment of acute obstructive pyelonephritis during pregnancy

目的探讨双J管置入术治疗妊娠期合并急性梗阻性肾盂肾炎的疗效及安全性。方法收集2014年1月至2015年6月在我院确诊为妊娠合并急性梗阻性肾盂肾炎的110例住院患者,根据治疗方式的不同分为手术治疗组(n=52)与保守治疗组(n=58),比较两种方法的治疗效果。结果手术治疗组与保守治疗组的治愈率分别为100.0%和79.3%,有显著性差异(P<0.05);两种治疗方式对于轻度肾积水患者的治愈率比较无显著性差异(P>0.05),而对于中、重度肾积水患者,置管术治疗的治愈率(100.0%)显著高于保守治疗的治愈率(50.0%)(P<0.05);所有患者均无严重并发症发生,出院后随访,所有患者均顺利诞下婴儿,婴儿无畸形;手术置管患者产后1个月返院均顺利拔除双J管。结论双J管置入术治疗妊娠期急性梗阻性肾盂肾炎,尤其对于患侧中、重度肾积水者,是一种疗效显著、安全、操作简单的微创方法,可作为临床上妊娠期急性梗阻性肾盂肾炎保守治疗无效时的重要辅助治疗手段,值得在临床上广泛推广。

Objective： To investigate the efficacy and safety of insertion of double J tube for treatment of acute obstructive pyelonephritis during pregnancy. Methods. The clinical data of 110 pregnancy women complicated with acute obstructive pyelonephritis in our hospital from January 2014 to June 2015 were retrospectively analyzed. The patients were divided into insertion group （n=52） and conservative treatment group （n=58）. The treatment effects were compared between the two groups. Results. The cure rate （100 0% vs. 79.3%） of the insertion group was significantly higher than that of the conservative treatment group （P〈0.05）. For the patients with moderate or severe hydronephrosis, the cure rate of insertion tube （100.0% vs. 50.0%） was significantly higher than conservative treatment （P〈0.05）. No serious complications occurred in all patients. The results of follow-up after discharge showed that all patients successfully gave birth to a baby, and the babies were without malformation. The double J tubes were Successfully removed in the patients one month postpartum. Conclusions. The treatment of acute obstructive pyelonephritis during pregnancy with insertion of double J tube,especially for the moderate or severe hydronephrosis.is an effect, safe, simple and minimally invasive method. It can be used as an adjuvant therapy for treatment of acute obstructive pyelonephritis during pregnancy when conservative treatment fails. It is worth to clinical practice widely.