输尿管镜弹道碎石术治疗妊娠合并输尿管结石（附52例报告）

目的 探讨妊娠合并输尿管结石的诊断和处理方法。方法 回顾分析我院2008年1月～2013年12月采用输尿管硬镜弹道碎石术治疗妊娠合并输尿管结石共52例患者临床资料。结果 52例患者中，上段结石18例，8例一次性碎石取石成功（44.4%），10例因输尿管推移、息肉、狭窄等仅放置双J管（55.6%）；下段结石34例均一次性碎石取石成功（100%）。手术时间10～40min，平均时间23min。术后所有患者腰腹痛、发热等症状消失。1例术后出现先兆早产（1.9%），经处理后缓解。结论 输尿管镜弹道碎石术治疗妊娠合并输尿管结石安全，损伤小，对输尿管下段结石碎石取石率高，是治疗妊娠期输尿管结石的有效方法之一。

Ureteroscopic pneumatic lithotripsy treating ureter calculi during pregnancy(A report of 52 cases)

Objective To report our experience in managing ureter calculi during pregnancy. Methods: A total of 52 pregnant women with ureteral stones treated with ureteroscopic pneumatic lithotripsy from January 2008 to December 2013 in our hospital were analyzed retrospectively. Results: Eighteen patients suffered upper segment ureter stones, and 8 of them were cured with stones successfully fragmented and extracted ,while the other 10 patients were only treated with double J stents placement because of stone dislocatione, ureteral polyps and stricture. Lower segment ureter stones in 34 patients were successfully fragmented and extracted. Operating time was 10~40mins, average operating time was 23 mins, and  symptoms such as flank pain and fever relieved. Threatened premature labor occurred in 1 patient post operatively but was well managed with no preterm delivery and no fetal loss. Conclusions: Ureteroscopic pneumatic lithotripsy has higher stone free rate in pregnant women with lower segment ureter calculi, may be a safe and effective procedure in treating ureter calculi during pregnancy.