输管尿镜下气压弹道碎石术治疗妊娠期输尿管结石引起上尿路梗阻

摘要

Objective To evaluate the feasibility and clinical efficacy of ureteroscopic pneumatic lithotrips in the treatment of upper urinary tract obstruction by ureteral calculi in pregnant women.Methods Thirty six women diagnosed with upper urinary tract obstruction by ureteral calculi during pregnancy were char-acterized with persistent and recurrent severe renal colic.Ureteroscope-guided pneumatic lithotripsy was per-formed.Results The ureteral calculi were successfully treated in 32 patients by ureteroscopic pneumatic litho-trips.Double-J ureteral stents were retained in four patients complicated with pyonephrosis,who were treated with extracorporeal shock wave lithotripsy after parturition.Renal colic and fever were absent after surgery.No abortion,prematurity,fetal death,ureter perforation or avulsion was noted.All pregnant women had full-term delivery and all newborns were healthy.Conclusion Ureteroscopic pneumatic lithotripsy could effectively and safely alleviate renal colic and treat obstruction in pregnant women with upper urinary tract obstruction by ure-teral calculi.%目的：探讨利用输尿管镜气压弹道碎石术治疗妊娠期输尿管结石引起上尿路梗阻的可行性及临床效果。方法对36例持续性或反复发作剧烈肾绞痛的妊娠期输尿管结石引起上尿路梗阻患者，采用输尿管镜下气压弹道碎石术治疗，观察手术疗效及安全性。结果输尿管镜下气压弹道碎石术一次性碎石成功32例，4例输尿管上段结石患者因合并脓肾予留置双 J 管，待患者妊娠结束后行体外冲击波碎石。术后所有患者的肾绞痛、发热等症状消失。36例均未出现流产、早产或死胎，无出现输尿管穿孔、撕脱等并发症，所有孕妇均足月分娩，新生儿发育均正常。结论输尿管镜下气压弹道碎石术治疗妊娠期输尿管结石引起上尿路梗阻能有效缓解患者疼痛，解除梗阻，且安全性高。