微创技术治疗孕期输尿管结石梗阻合并急性上尿路感染的效果

Effect of minimally invasive technique in the treatment of ureteral calculi obstruction complicated with acute upper urinary tract infection during pregnancy

目的探讨微创技术治疗孕期输尿管结石梗阻合并急性上尿路感染(UTI)的效果。方法选取2013年1月~2018年10月我院收治的120例孕期输尿管结石梗阻合并UTI患者作为研究对象,按照随机数字表法分成A组(60例)和B组(60例)。A组采取孕妇输尿管急性梗阻紧急处理,B组采取输尿管镜钬激光碎石或单纯内支架引流治疗。比较两组的炎性反应指标、分娩结局与治疗效果。结果B组术后白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白细胞(WBC)指标明显低于A组,B组的引产、流产率,分娩后1~2个月治疗输尿管结石成功率低于A组,分娩活婴率、分娩后4~5周拔除输尿管支架管成功率高于A组(P<0.01)。结论孕期输尿管结石梗阻合并UTI患者采取微创技术治疗,治疗效果佳,可明显降低治疗后炎性指标,手术方案有效,可改善分娩结局。

Objective To investigate the effect of minimally invasive technique in the treatment of ureteral calculi obstruction combined with acute upper urinary tract infection (UTI) during pregnancy. Methods A total of 120 patients with ureteral calculi obstruction and UTI who were admitted to our hospital from January 2013 to October 2018 were enrolled in the study. They were divided into group A (60 cases) and group B (60 cases) according to random number table method. Group A was treated with acute obstruction of ureteral obstruction in pregnant women, and group B was treated with ureteroscopic holmium laser lithotripsy or simple internal stent drainage. The inflammatory response indicators, delivery outcomes and treatment effects were compared between the two groups. Results The levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), C-reactive protein (CRP) and white blood cells (WBC) in group B were significantly lower than those in group A, the rate of induced abortion in group B and the success rate of ureteral calculi 1~2 months after delivery were lower than that of group A, the survival rate of delivery and successful rate of removal of ureteral sten 4 to 5 weeks after delivery were higher than those of group A (P<0.01). Conclusion Patients with ureteral calculi obstruction and UTI during pregnancy are treated with minimally invasive techniques, the treatment effect is good, the inflammatory index after treatment is significantly reduced, and the surgical plan is effective, which can improve the outcome of delivery.