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目的总结妊娠期合并泌尿系结石安全有效的治疗方法。方法回顾性分析98例妊娠期合并泌尿系结石的病例资料,所有患者均给予黄体酮、6-542肌注及抗生素等保守治疗,失败者膀胱镜下留置输尿管内双J管治疗,再失败则肾穿刺造瘘术。结果保守治疗24h内症状缓解、1个月内结石排出51例(52.0%);因保守治疗失败给予留置输尿管内双J管治疗47例(48.0%),其中,留置双J管失败行肾穿刺造瘘术6例(6.1%)。47例患者留置双J管24h内症状均明显缓解,1个月内结石完全排出16例,3个月结石完全排出30例,因妊娠结束结石未排出接受碎石治疗17例;置管期间出现膀胱刺激征及发热3例,考虑导管相关性感染,予抗感染治疗后症状均缓解。所有患者治疗期间耐受性良好,无严重的并发症发生,无妊娠期内接受输尿管镜下钬激光碎石术治疗的病例。结论妊娠合并泌尿系结石,首选保守治疗,若保守治疗无效,膀胱镜下输尿管内置双J管或经皮肾穿刺造瘘术均是安全有效的治疗方法。
Objective To summarize the safe and effective treatment of urolithiasis during pregnancy. Methods A retrospective analysis of 98 cases of pregnancy with urinary stones, all patients were given progesterone, 6-542 intramuscular injection of antibiotics and other conservative treatment, losers in cystoscopy ureter double J tube treatment, and then failed Renal puncture ostomy. Results The symptoms were relieved within 24 hours of conservative treatment, and 51 cases (52.0%) of stones were discharged in one month. 47 cases (48.0%) were treated with double J tube indwelling ureter due to failure of conservative treatment. Among them, 6 cases of ostomy (6.1%). 47 patients were placed in double J tube 24h symptoms were significantly relieved within 1 month completely discharged in 16 cases of stones, stones were completely discharged in 3 months in 30 cases, stones were not discharged due to the end of pregnancy to receive lithotripsy in 17 cases; occurred during catheterization Bladder irritation and fever in 3 cases, consider catheter-related infections, to anti-infection symptoms were relieved. All patients were well tolerated during treatment, with no serious complications and no cases of ureteroscopic holmium laser lithotripsy during pregnancy. Conclusion Pregnancy with urinary stones, the preferred conservative treatment, if conservative treatment fails, cystoscopic ureteral double J tube or percutaneous nephrostomy are safe and effective treatment.