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目的:探讨利用微创技术治疗妊娠期输尿管结石合并感染的可行性及临床效果。方法:2006年5月～2010年4月对21例妊娠期输尿管结石合并泌尿系感染患者行微创技术治疗。21例患者孕6～36周,平均24周。结石最大径5～15 mm。左侧输尿管结石9例,右侧12例。输尿管结石上段5例,中段10例,下段6例。尿常规:白细胞++～++++,伴不同程度发热。单纯留置双J管8例,12例采用输尿管镜下钬激光碎石术,1例行经皮肾穿刺造瘘术。结果:所有患者肾绞痛、发热等急症症状经治疗后消失。结石一次性取净12例,留置双J管及肾造瘘管者至分娩后再行微创手术取石。无一例发生先兆流产或早产等,所有患者均顺利生产,婴儿健康。无输尿管穿孔及其他并发症发生。结论:利用微创技术治疗妊娠期输尿管结石合并感染安全有效。
Objective: To explore the feasibility and clinical effect of using minimally invasive technique in the treatment of pregnancy-associated ureteral stones complicated with infection. Methods: From May 2006 to April 2010, 21 patients with ureteral calculi during pregnancy with ureteral calculi underwent minimally invasive surgery. 21 cases of pregnant 6 to 36 weeks, an average of 24 weeks. The largest diameter of stones 5 ~ 15 mm. Left ureteral calculi in 9 cases, right in 12 cases. Upper ureteral calculi in 5 cases, 10 cases in the middle, the lower 6 cases. Urine: white blood cells ++ ~ ++++, with varying degrees of fever. Pure indwelling double J tube 8 cases, 12 cases of ureteroscopic holmium laser lithotripsy, 1 case of percutaneous nephrostomy. Results: All patients with renal colic, fever and other symptoms disappeared after treatment. One-time removal of stones in the net in 12 cases, indwelling double J tube and kidney fistula to delivery after minimally invasive surgery stone. No case of threatened abortion or premature delivery, etc., all patients were successfully produced, baby health. No ureter perforation and other complications occurred. Conclusion: It is safe and effective to treat minimally invasive ureteral stones during pregnancy.