输尿管双J管在22例妊娠期肾绞痛治疗中的应用  

Treatment of 22 Cases of Renal Colic with Double-J Stent during Pregnancy

作　　者：王雪姣[1] 杜鹃[1] 

机构地区：[1]中国医科大学附属盛京医院,辽宁沈阳110000

出　　处：《实用妇产科杂志》2012年第8期665-668,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨留置双J管治疗妊娠期肾绞痛的有效性及安全性。方法:回顾性分析2000年6月至2010年11月因肾绞痛就诊于盛京医院泌尿外科及产科并留置双J管治疗的22例妊娠期患者的临床资料。分析其临床特征,并观察留置双J管治疗的疗效。结果:所有患者在留置双J管和辅助抗感染治疗后,肾绞痛、发热及恶心、呕吐等症状均于治疗后1～5天明显缓解;术后3天复查见镜下血尿(36%)、脓尿(45%)、血白细胞升高(18%)和血肌酐>115μmol/L(4.5%)、血尿素氮>7.2mmol/L(0),比例较治疗前降低;术后1个月B超检查见16例患者肾积水消失,6例患者仅伴轻度肾积水。22例患者无产科并发症发生,仅1例患者于留置双J管近3个月时出现双J管置入术后并发症,见发热及腰部酸痛症状。22例患者双J管留置时间1～7个月,平均3.4个月,其中21例顺利渡过围生期,仅1例因左侧结核性渗出性胸膜炎,放弃胎儿而引产。结论:对于保守治疗无效的妊娠期肾绞痛患者,置入输尿管双J管对缓解肾绞痛症状,减轻肾积水程度,和维持妊娠是一种安全、有效的方法。Objective：To evaluate the therapeutic safety and efficacy of double-J stent in renal colic com- bined with pregnancy. Methods：Clinical data of 22 patients of renal colic during pregnancy who were treated with double-J stent in Shengjing hospital from June 2000 to November 2010 were collected and retrospective- ly analyzed. Results：All the patients received the double-J stent insertion and the subsequent anti-infection treatment. After 1 -5 days of all the treatment, the symptoms of pain, fever, nausea and vomiting in all pa- tients were obviously relieved. Three days after the treatment, the percentage of microscopic hematuria, pyu- ria, elevated white blood cell, elevated serum creatinine and urinary nitrogen was decreased, compared to the preoperative level. One month after the treatment, the hydronephrosis of 16 patients were vanished and the hydronephrosis in＇another 6 patients were alleviated. All patients had no pregnancy complications, while only one patient had symptoms of renal colic and fever near three months after the treatment of double-J stent. The retention time of double-J stent in all patients varied from 1 to 7 months, the average retention time was 3.4 months. Among the 22 patients,21 patients successfuly delivery, only one patient took induced a- bortion as the left tuberculous exative pleurisy. Conclusions： For pregnant women with renal colic, if conser- vative management fails, the double-J stent treatment is a less invasive and efficient method to relieve the pain and control the hydronephrosis.

关 键 词：妊娠 肾绞痛 双J管 治疗 

分 类 号：R714.25[医药卫生—妇产科学]