摘要
目的探讨对孕前尿路结石进行预处理的适应证与lf缶床价值。方法76例孕前获诊尿路结石患者按随机与自愿原则分为预处理组35例和待处理组41例。其中预处理组肾结石16例18侧、输尿管结石19例23侧，属孤立肾1例，根据结石类型、部位在孕前采用体外震波碎石（ESWL）、经皮肾镜或输尿管镜取石（PCNL）；待处理组肾结石18例21侧、输尿管结石23例27侧，孕前定期复查。监测两组受孕及孕后继发尿路积水、肾绞痛和肾功能情况。结果预处理组孕前均排尽结石。33例（94％）受孕后6～9个月发生尿路积水7例（21％）、肾绞痛9例（27％）和肾功能不全1例（3％），无新增结石及妊娠期高血压病例。3例（9％）行双J管引流，其余保守治疗缓解，均顺利足月分娩；待处理组34例（82％）受孕后3～6个月继发尿路积水2l例（6l％）、肾绞痛25例（73％）、肾功能损害8例（22％）及肾性高血压5例（14％）。22例（64％）保守治疗无效需配合双J管置入、肾造痿或腔内碎石等处理，2例术后出现异常宫缩。1例因持续尿路感染及肾功能不良终止妊娠，其余病例安全渡过围产期。两组孕期与尿路梗阻有关的并发症发生率比较差异有显著性意义（P〈0．01）。结论对孕前尿路结石尤多发性、孤立肾或双侧肾输尿管结石进行预处理可大大降低孕期尿路积水、肾绞痛及肾功能损害的发生机率和处理风险，提高妊娠期母婴的安全性。
Objectives To investigate the indication and clinical value of pretreatment to pregestational urolithiasis. Methods 76 patients of pregestational urolithiasis were divided into two groups randomly and voluntarily： pretreatment group with 35 cases and non -treatment group with 41 cases. The pretreatment group had lithonephria in 16 cases,18 sides,lithureteria in 19 cases,23 sides,solitary kidney 1 case. Extracorporal shock wave lithotripsy （ESWL） and percutaneous nephrolithotomy （PCNL） （ were used according to type and location of calculi. In the non - treatment group there were lithonephria in 18 cases,21 sides,lithureteria,in 23 cases,27 sides. Periodic examination was used before pregnancy. To observe the situation of urinary dropsy,nephrocolic and kidney function. Results The pretreatment group ejected calculi completely before pregnancy. 33 cases （94%） with conception during 6 -9 months had urinary dropsy in 7 cases （21%） ,nephrocolic in 9 cases （27%） and renal insufficiency （3%） ,without new calculi formation and hypertension in pregnancy. 3 cases （9%） were drained by double J catheter,others managed by conservative treatment. They all had full term delivery smoothly. In the non -treatment group 34 cases （83%） with conception during 3 -6 months had urinary dropsy in 21cases （61%）, nephrocolic in 25 cases （73%） ,renal damage in 8 cases （22%） and renal - hypertension in 5 cases （14%）. 22 cases （64%） were treated by indwelled double J catheter,nephrostomy or endoscopic lithotripsy when conservative treatment was ineffective,2 cases had abnormal uterine contractions after operation. 1 case ended pregnancy because of continuous urinary infection and renal insufficiency, others passed perinatal period safely. The difference of complications about gestational period and urinary tract obstruction between two groups was significant（ p 〈0.01 ）. Conclusions The pretreament to pregestational urolithiasis especially multiple calculi ,lithonephria and lithurete
出处
《国际泌尿系统杂志》
2006年第3期293-296,共4页
International Journal of Urology and Nephrology
关键词
尿路结石
妊娠
Urinary calculi
Pregnancy
