输尿管软镜在中晚期妊娠合并症状性结石16例中治疗体会  

Through flexible ureteroscope in middle and late pregnancy complicated with symptomatic gallstone treatment experience 16 cases

作　　者：范先明[1] 郭昭建[1] 林剑锋[1] 王世先[1] 涂建平[1] 叶振扬[1] 郑健忠[1] 梁福律 

机构地区：[1]福建中医药大学附属厦门市第三医院泌尿外科,361100

出　　处：《中国医师进修杂志》2014年第33期49-51,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨输尿管软镜治疗中晚期妊娠合并症状性结石的可行性与临床疗效.方法 回顾性分析中晚期妊娠合并症状性结石16例患者的临床资料,所有患者均解痉、镇痛等保守治疗无效,采用输尿管软镜进行治疗.结果 10例一期成功碎石,3例术中发现为结石性脓肾,单纯放置D-J管引流,1例因结石较大,改行经皮肾穿刺造瘘术.术后症状消失,肾集合系统分离完全消失13例,3例好转.1例合并脓肾的患者再次出现严重感染,拔出D-J管,改行经皮肾穿刺造瘘持续引流.所有患者均足月分娩,无因操作而引起早产、脓毒血症、感染性休克等严重并发症.结论 输尿管软镜治疗中晚期妊娠合并症状性结石,临床效果较好、手术创伤较小,是一种安全、有效的方法.Objective To explore through flexible ureteroscope in the treatment of middle and late pregnancy complicated with symptomatic gallstone feasibility and clinical efficacy.Methods Retrospectively analyzed the clinical data of middle and late pregnancy patients with symptoms of calculi：all patients were performed antispasmodic,analgesic and other conservative treatments,through flexible ureteroscope for treatment.Results Ten cases of success found in gravel,3 cases performed surgery for calculous pyonephrosis simply place the D-J tube drainage,1 case due to larger stones,but changed to percutaneous renal puncture and fistulation.Symptoms disappeared after surgery,13 cases of separation disappeared completely and 3 cases renal collecting system improved.One case of severe infection complicated with pyonephrosis appeared again,pull the D-J tube,but changed to percutaneous renal puncture nephrostomy drainage.All patients were term delivery and not due to operation resulting from prematurity,sepsis,septic shock and other serious complications.Conclusion Through flexible ureteroscope in the treatment of middle and late pregnancy complicated with symptomatic gallstone is a safe and effective way with better clinical effects,less surgical trauma.

关 键 词：输尿管软镜 妊娠 结石 

分 类 号：R714.258[医药卫生—妇产科学]