孕妇肾积水的诊断治疗研究  

Diagnosis and treatment of hydronephrosis during pregnancy

作　　者：张万峰[1] 姜德智[2] 李明[1] 王贵平[1] 丁晓晖[1] 王洪杰[1] 

机构地区：[1]大庆龙南医院(齐齐哈尔医学院第五附属医院)泌尿外科,黑龙江大庆163453 [2]大庆油田总医院集团南区医院外科,黑龙江大庆163000

出　　处：《中国现代医学杂志》2015年第3期56-58,共3页China Journal of Modern Medicine

摘　　要：目的探索女性妊娠期合并肾积水的原因和治疗方法。方法回顾分析2000-2011年,大庆龙南医院78例妊娠合并肾积水患者,其中59例采用内科保守治疗,11例采用膀胱镜下输尿管置管,8例采用输尿管镜术+弹道碎石的方法治疗。结果 78例患者肾绞痛症状均得到缓解,肾盂积水不同程度减少,77例治疗后顺利完成妊娠,1例因恐惧药物和手术影响胎儿自行终止妊娠后完成输尿管镜碎石。结论轻度和中度妊娠期肾积水合并肾绞痛者经保守治疗大部分可以获得缓解,妊娠合并肾绞痛反复发作或重度肾积水的患者采用经膀胱镜输尿管置双J管引流术效果良好,输尿管结石妊娠患者输尿管镜弹道碎石效果可靠、生理干扰少、损伤小、对胎儿比较安全。【Objective】To evaluate the pathogenesis and effective therapy manners for hydronephrosis during pregnancy.【Methods】A total of 78 pregnant women with hydronephrosis from 2000 to 2011 were reviewed. Among the 78 cases, 59 cases were treated by conservative measures, 11 cases by placing intraureteral double-J-catheter under cystoscope, and 8 cases by placing intraureteral double-J-catheter after ureteroscopic pneumatic lithotripsy.【Results】Renal colic was relieved and hydronephrosis was alleviated in all the pregnant women. Among them 77 cases gave birth to healthy babies after safe perinatal period, 1 case terminated the pregnancy voluntarily for fear of the impact of drugs and operation on the fetus. 【Conclusions】Most pregnant women with mild or moderate hydronephrosis with renal colic can be alleviated by conservation treatment. For pregnant women with recurrent renal colic or severe hydronephrosis, placement of double-J-catheter is an effective intervention choice. Ureteroscopic pneumatic lithotripsy has a little physical interference and injury to pregnant woman and is reliable and safe to fetus.

关 键 词：妊娠 肾积水 诊断 治疗 

分 类 号：R692[医药卫生—泌尿科学]