中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2017, Vol. 46 ›› Issue (5): 453-456.doi: 10.12007/j.issn.0258-4646.2017.05.017

• 论著 • 上一篇    下一篇

妊娠期输尿管结石的外科治疗

谭书韬,吴斌   

  1. 中国医科大学附属盛京医院泌尿外科,沈阳 110004
  • 收稿日期:2016-10-31 出版日期:2017-05-30 发布日期:2017-05-18
  • 通讯作者: 吴斌 E-mail:wubin_cmu@126.com
  • 作者简介:谭书韬(1986 -),男,讲师,博士 .

Treatment of Symptomatic Ureteral Calculi during Pregnancy

TAN Shutao,WU Bin   

  1. Department of Urology,Shengjing Hospital,China Medical University,Shenyang 110004,China
  • Received:2016-10-31 Online:2017-05-30 Published:2017-05-18

摘要: 目的 探讨双 J 管置入和输尿管镜碎石术对于保守治疗无效的妊娠期输尿管结石的治疗效果。方法 回顾性分析中国医科大学附属盛京医院泌尿外科 2007 年 1 月至 2015 年 1 月收治的保守治疗无效的 38 例妊娠期输尿管结石患者。根据治疗方法不同分为双 J 管组(n = 21)和输尿管镜组(n = 17)。比较 2 种治疗方法在成功率、并发症、手术时间、治疗总费用、住院时间等 方面的差异。结果 双 J 管组成功 17 例( 81.0%)。输尿管镜组成功 15 例(88.2%)。双 J 管组并发症发生率(14.3%)较输尿管镜 组(11.8%)高。双 J 管组在手术时间、花费及住院时间方面均较输尿管镜组低(P < 0.05)。成功施行输尿管镜手术的患者无需 进一步治疗,双 J 管组则需要在孕妇分娩后进一步处理结石。结论 输尿管镜手术和置入双 J 管均为治疗妊娠期输尿管结石的 有效方法。输尿管镜手术成功率高,可直接处理结石,而置入双 J 管简便、快捷,在某些情况具有一定优势。需根据患者的不同 情况选择合适的治疗方法。

关键词: 输尿管结石, 妊娠期, 双 J 管, 输尿管镜

Abstract: Objective To present our experience with the management of symptomatic ureteral calculi during pregnancy and to compare the efficacy of two treatments:double-J stent insertion and ureteroscopy. Methods In a retrospective study between January 2007 and January 2015,38 pregnant women were treated for symptomatic ureteral calculi in our hospital. The patients were divided into two groups based on whether they received double-J stent insertion(n = 21)or ureteroscopic lithotripsy(n = 17). We collected and compared the patients’characteristics and treatment outcomes,such as success ratio,rate of complications,surgical time,medical costs,and hospitalization time. Results In the double-J group, the insertion of a double-J stent was possible for 17 of 21 patients(success rate,81.0%). In the ureteroscopy group,15 of 17 patients had complete calculi fragmentation(success rate,88.2%). Complications in the double-J stent retention group were slightly higher than in the ureteroscopic litho- tripsy group. The medical costs and hospitalization time required to perform ureteroscopic lithotripsy were significantly higher compared to double-J stent insertion. Patients in the double-J group contended with stones after delivery. Conclusion Both of double-J stent insertion and ureteroscopic lithotripsy are effective for the treatment of symptomatic ureteral calculi during pregnancy. The success rate of ureteroscopy ,which can directly dis- rupt stones,was higher. However,double-J stent insertion costs less and is simple and convenient. The technique that is chosen to be performed de- pends on the patient’s practical situation and personal preference.

Key words: ureteral calculi, pregnancy, double-J stent insertion, ureteroscopy

中图分类号: 

  • R693.4
[1] 王佳莉,任卫东,王欣,赵梦峤. 超声动脉分析技术评价妊娠期高血压患者的颈动脉 径向应变和应变率[J]. 中国医科大学学报, 2017, 46(8): 686-688.
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[6] 王文迪,杜鹃. 妊娠期糖尿病孕妇脂蛋白相关磷脂酶A2活性的变化及临床意义[J]. 中国医科大学学报, 2014, 43(8): 738-741.
[7] 李秋玲,刘思诗,崔红,郑东明,刘彩霞. 妊娠期子宫脱垂与宫颈机能不全孕妇紧急宫颈环扎术后妊娠结局关系的临床分析[J]. 中国医科大学学报, 2013, 42(10): 891-893.
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