D-J管长期植入联合输尿管软镜钬激光治疗妊娠合并输尿管结石的有效性及安全性研究  

A study of the effectiveness and safety of long-term implantation of D-J tube combined with flexible ureteroscope holmium laser in the treatment of pregnancy complicated with ureteral calculi

作　　者：单永玮 姚家喜 杨发英 牛世杰[1,2,3,4] SHAN Yongwei;YAO Jiaxi;YANG Faying;NIU Shijie(Department of Urology,Zhangye People's Hospital Affiliated to Hexi University,Zhangye734000,China;Clinical Medical College,Hexi University,Zhangye734000,China;Institute of Urology,Hexi University,Zhangye734000,China;Medical Quality Control Center of Urology of Zhangye in Gansu Province,Zhangye734000,China)

机构地区：[1]河西学院附属张掖人民医院泌尿外科,甘肃张掖734000 [2]河西学院临床医学院,甘肃张掖734000 [3]河西学院泌尿外科研究所,甘肃张掖734000 [4]甘肃省张掖市泌尿外科医疗质量控制中心,甘肃张掖734000

出　　处：《中国现代医生》2020年第18期59-62,66,共5页China Modern Doctor

基　　金：甘肃省河西学院科研创新与应用校长基金项目(XZ2017003)。

摘　　要：目的探讨妊娠期合并输尿管结石患者急诊泌尿外科腔内技术处理的安全性和有效性。方法选取河西学院附属张掖人民医院泌尿外科2016年3月~2017年3月收治的26例妊娠期合并输尿管结石患者,止痛药物无效后行D-J管长期植入术,观察等待至妊娠期或哺乳期结束,对仍有结石患者采用输尿管软镜联合钬激光碎石。观察比较治疗前后临床症状、尿常规和影像学检查改变,及患者结石和妊娠结局。结果26例患者经治疗后,肾绞痛、发热等症状完全消失。留置双J管至分娩后,20例未见结石残留。所有患者未发生先兆流产或早产等,无输尿管穿孔及其他并发症。1例在留置双J管后出现排尿后腰部不适,3 d后自行缓解。术后肉眼血尿1例,6 d后血尿症状改善。26例均顺利生产,婴儿健康。结论D-J管长期植入联合后期钬激光碎石治疗妊娠合并尿路结石安全、有效。Objective To explore the safety and effectiveness of endourological treatment in emergency urology for patients with ureteral calculi during pregnancy.Methods From March 2016 to March 2017,twenty-six patients with ureteral calculi during pregnancy admitted to the Department of Urology of Zhangye People's Hospital Affiliated to Hexi University underwent long-term implantation of D-J tube after the analgesic drugs were ineffective.Through observation and waiting,the patients who still had calculi until the end of pregnancy or lactation were treated with flexible ureteroscope combined with holmium laser lithotripsy.The changes of clinical symptoms,urine routine and imaging examination results before and after treatment as well as the patients'calculi and pregnancy outcomes were observed and compared.Results After treatment,the symptoms of renal colic and fever,etc.disappeared completely in the twenty-six patients.No calculi remained in twenty cases after double J tube indwelling until delivery.All the patients had no threatened abortion or premature delivery,and no ureteral perforation or other complications.One patient suffered waist discomfort after urination after the indwelling of double J tube,and the symptom was automatically relieved after 3 d.1 case of postoperative gross hematuria and 6 d improved hematuria symptoms.All the twenty-six patients were successfully delivered of healthy babies.Conclusion Long-term implantation of D-J tube combined with later holmium laser lithotripsy is safe and effective in the treatment of pregnancy complicated with lithangiuria.

关 键 词：输尿管结石 妊娠 钬激光 输尿管软镜 

分 类 号：R699[医药卫生—泌尿科学]