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目的总结妊娠期输尿管结石的诊治经验。方法对15例妊娠期输尿管结石患者行B超、CT尿路造影(CTU)及磁共振尿路造影(MRU)等检查,行药物排石、双J管置入术及经输尿管镜气压弹道碎石术等治疗。结果B超发现输尿管结石8例;CTU检查发现输尿管结石2例;MRU检查发现输尿管结石5例;3例影像学未直接发现结石影,但B超发现肾盂输尿管扩张。10例行药物保守治疗,结石排出,其中2例行经输尿管镜气压弹道碎石术。5例介入治疗者中,4例行双J管置入术,1例在B超定位下行经皮肾穿刺造瘘术。术后所有孕妇均顺利生产,婴儿健康。结论妊娠期输尿管结石的诊治需兼顾孕妇及胎儿的利益,尤其要考虑到可能对胎儿的影响。
Objective To summarize the diagnosis and treatment of ureteral stones during pregnancy. Methods Fifteen patients with ureteral calculi during pregnancy underwent ultrasound, CT urography and magnetic resonance urography (MRU). The patients were discharged with drugs, double J tube and pneumatic ballistic ureteroscopy Shishi and other treatment. Results B-mode ureteral calculi was found in 8 cases; ureteral calculi was detected in 2 cases by CTU; ureteral calculi was found in 5 cases by MRU. No imaging was found in 3 cases, but ureteropelvic dilation was found in B-mode ultrasonography. 10 cases of conservative treatment of drugs, stones were discharged, of which 2 cases underwent ureteroscopic pneumatic lithotripsy. Of the 5 patients who underwent interventional therapy, 4 were treated with double-J tube implantation and 1 underwent percutaneous nephrostomy with B-ultrasound. All pregnant women were successfully produced after the baby healthy. Conclusion The diagnosis and treatment of ureteral stones in pregnancy need to take into account the interests of pregnant women and fetuses, especially taking into account the possible impact on the fetus.