孕妇输尿管结石合并肾绞痛28例的诊治

目的探讨孕妇输尿管结石并肾绞痛有效的诊断和治疗方法。方法总结28例输尿管结石合并。肾绞痛孕妇,保守治疗好转25例,3例保守治疗无效者置放输尿管双J管。结果28例孕妇症状均缓解,均顺利度过围产期。分娩后结石自行排出25例,体外冲击波碎石（ESWL）治愈3例。结论黄体酮、硫酸镁注射液具解痉止痛和保胎双重功效,保守治疗无效者置放输尿管双J管具操作简单、创伤小、疗效确切的优点。     

孕期输尿管结石并肾绞痛的输尿管镜腔内置双J管疗效分析

目的：评估输尿管镜腔内置双 J 管术治疗孕期输尿管结石并肾绞痛的疗效及安全性。方法对58例经保守治疗无效的孕期输尿管结石并肾绞痛患者行输尿管镜腔内置双 J 管术,观察手术疗效及安全性。结果所有患者置入双 J 管后肾绞痛症状均缓解;58例双 J 管留置时间3～8个月,术后复查泌尿系彩色多普勒超声检查发现结石自行排出后拔除双 J 管14例;留置双 J 管至分娩后1个月行输尿管镜碎石取石术26例、行体外震波碎石术18例。58例均顺利足月分娩,新生儿均健康,无因肾绞痛而发生流产、早产等不良事件。结论输尿管镜腔内置双 J 管术治疗孕期输尿管结石并肾绞痛疗效好,且安全。     

妊娠合并输尿管结石致顽固性肾绞痛的腔内处理

【目的】探讨妊娠合并输尿管结石致顽固性肾绞痛安全有效的腔内处理方法。【方法】妊娠合并输尿管结石致肾绞痛经保守治疗无效患者14例,孕7~34周,平均27周。结石最大径5~12mm。输尿管上段结石8例,中段3例,下段3例。上段结石中6例单纯留置双J管,2例将结石推回肾盂后留置双J管。中下段结石中3例采用输尿管镜下气压弹道碎石术击碎结石,3例应用输尿管镜下双频激光碎石。【结果】12例术后肾绞痛消失;2例单纯放置双J管者仍有间断轻微肾绞痛,服用解痉药物可以缓解。8例未碎石在结石排出前每3个月更换双J管。14例孕妇均顺利生产,婴儿健康。【结论】妊娠合并输尿管结石致顽固性肾绞痛患者采用逆行输尿管插管或输尿管镜取石术安全有效。     

腔内泌尿技术Ⅰ期或Ⅱ期手术治疗妊娠期合并结石致顽固性肾绞痛26例

目的:探讨妊娠合并结石致顽固性肾绞痛安全有效的临床治疗方法。方法:妊娠合并输尿管结石致肾绞痛经保守治疗无效患者26例,孕7～34周,平均27周。结石最大径4～13mm。输尿管上段结石8例,中段5例,下段13例。18例(中下段结石患者)采用Ⅰ期手术(输尿管镜下气压弹道碎石取石),8例(上段结石患者)采用Ⅱ期手术(即先放置双J管,生育1个月后行Ⅱ期输尿管镜碎石取石治疗)。结果:24例术后肾绞痛消失;2例单纯放置双J管者仍有间断轻微肾绞痛,用解除输尿管平滑肌痉挛药物可以缓解。8例未碎石患者在结石排出前每4个月更换双J管。26例均顺利度过围产期,并产健康婴儿。结论:腔内泌尿技术治疗妊娠合并输尿管结石致顽固性肾绞痛是安全有效。     

妊娠期合并输尿管结石致顽固性肾绞痛的临床研究

目的探讨妊娠合并输尿管结石致顽固性肾绞痛安全有效的临床处理方法。方法妊娠合并输尿管结石致肾绞痛经保守治疗无效患者13例,孕期7～34周,平均27周。结石最大直径为4～12mm。输尿管上段结石7例,中段4例,下段2例。上段结石中6例单纯留置双J管,1例将结石推回肾盂后留置双J管。中下段结石中5例采用输尿管镜下气压弹道碎石术击碎结石,1例单纯留置双J管。结果13例术后肾绞痛消失;1例单纯放置双J管者仍有间断轻微肾绞痛,服用解痉药物可以缓解。8例未碎石患者在结石排出前每6个月更换双J管。13例均较顺利度过围产期,并产健康婴儿。结论妊娠合并输尿管结石致顽固性肾绞痛患者采用逆行输尿管插管或输尿管镜取石术安全有效。     

妊娠期合并肾绞痛应用双J管13例的护理

目的 探讨妊娠期输尿管结石致肾绞痛患者行双J管内引流术的护理方法与效果.方法 回顾分析南阳市医专第一附属医院2009-2011年收治的13例放置双J管治疗妊娠期输尿管结石的临床资料,并进行针对性护理.结论 13例共14侧置入双J管后肾绞痛全部缓解,未出现先兆流产,并顺利度过围生期,顺产健康新生儿.结论 置入双J管治疗孕妇输尿管结石是安全、有效的方法.     

U100双频双脉冲激光治疗妊娠期输尿管结石16例

目的探讨输尿管镜下U100激光治疗妊娠期输尿管结石的临床疗效。方法对16例临床确诊输尿管结石致肾绞痛保守治疗无效的孕妇在输尿管镜下应用U100双频双脉冲激光行碎石术。结果 16例均原位碎石成功,平均碎石时间6 m in,术后患者肾绞痛、发热等症状消失,结石均全部排空,无明显产科并发症。结论输尿管镜下U100激光碎石术治疗妊娠期输尿管结石安全、有效,值得临床推广应用。     

妊娠期输尿管结石合并肾绞痛行输尿管支架管植入术的护理

目的探讨妊娠期输尿管结石合并肾绞痛行输尿管支架管植入术的围手术期护理。方法回顾分析2016年8月-2017年7月我院收治的15例妊娠期输尿管结石合并肾绞痛经保守治疗无效,行输尿管支架管植入术患者的临床资料,总结围手术期护理要点及措施。结果 15例行输尿管支架管植入术后肾绞痛均消失,顺利完成妊娠。10例妊娠结束时结石已排出,2例行输尿管镜碎石取石术,3例行体外冲击波碎石术,所有患者均顺利拔除支架管。结论输尿管支架管植入术是治疗妊娠期输尿管结石合并肾绞痛的有效方式,做好围手术期护理,加强出院指导,有利于孕妇和胎儿的健康。     

留置双J管治疗妊娠期上尿路结石并肾绞痛

目的:探讨留置双J管治疗妊娠期上尿路结石并发肾绞痛的有效性及安全性。方法:1996年5月-2007年6月对14例妊娠期上尿路结石并发肾绞痛的患者行表面麻醉下留置双J管治疗。结果:14例患者留置双J管时间2~7个月,平均4.5个月。14例患者在留置双J管后肾绞痛症状均缓解;1例置管后2周双J管脱出,再次留置2条双J管后未见脱出;排尿后患侧腰痛2例,1例出现肉眼血尿。无产科并发症。14例孕妇均顺利生产,婴儿健康;分娩后,4例结石自行排出,10例行体外冲击波碎石治疗。结论:经膀胱镜或输尿管镜留置双J管治疗妊娠期上尿路结石并发肾绞痛是一种安全有效的方法。     

妊娠期肾绞痛的输尿管镜治疗

目的 探讨输尿管镜技术在妊娠肾绞痛治疗中的意义.方法 2007年10月～2011年10月收治妊娠肾绞痛患者259例,161例因保守治疗无效接受输尿管镜治疗,孕周13～38周,平均24.67周.结果139例发现结石,其中输尿管上段结石43例、下段结石87例、双侧上段结石9例,结石大小0.5～2.3 cm,术后24 h肾绞痛症状消失者136例,其余3例术后24 ～ 72 h疼痛症状缓解,短期肉眼血尿28例,发热12例,留置输尿管双J管2～12周,无输尿管穿孔与损伤;随访妊娠情况:流产4例、早产5例、剖宫产27例、经阴道产103例,无胎儿畸形及发育异常.结论 输尿管镜治疗妊娠期肾绞痛,具有减少解痉镇痛用药量、快速引流尿液、缓解腰腹疼痛、保护患肾功能、保障母胎发育的特点,术中适当应用气压弹道或超声碎石是安全的.     

Role of the plain radiograph and urinalysis in acute ureteric colic.

OBJECTIVE: (1) To determine the accuracy of accident and emergency (A&E) doctors' diagnosis of radio-opaque ureteric calculi on plain abdominal radiographs; (2) to study the predictive value of haematuria with a history suggestive of ureteric colic. DESIGN: A prospective study of all patients seen in a three month period with a provisional diagnosis of ureteric colic. Intravenous urography (IVU) was used as the gold standard for diagnosis of ureteric calculi. SETTING: The accident and emergency department and medical unit of a large teaching hospital. SUBJECTS: 60 patients who were admitted with an initial diagnosis of ureteric colic, 51 subsequently undergoing intravenous urography. RESULTS: A&E doctors achieved a calculated sensitivity of 29% (95% confidence intervals 13% to 49%) and a specificity of 73% (52% to 90%) for identification of renal calculi on plain abdominal radiograph, compared with figures of 68% (48% to 84%) and 96% (78% to 100%) respectively for consultant radiologists. The difference between these results was highly significant (P = 0.0011). No patient with a definitive diagnosis of ureteric colic had a negative result for haematuria on urinary dipstick analysis. CONCLUSIONS: A&E doctors are poor at identifying radio-opaque ureteric calculi on plain abdominal radiographs. If haematuria is absent on urinalysis then ureteric colic is an unlikely diagnosis.     

腔内超声诊断输尿管下段结石的价值探讨

目的探讨腔内超声对输尿管下段结石的诊断价值.方法对临床疑诊尿路结石患者,按常规扫查肾脏和输尿管中上段,当发现肾盂扩张并排除了输尿管中上段结石后,改为腔内(阴道或直肠)超声检查确定有否输尿管下段结石,并与放射检查结果进行对照.结果 80例经腹部超声检查高度怀疑输尿管下段结石者(膀胱未充盈状态),其中79例经腔内超声检查得到证实,与X-线检查结果一致.1例被排除,造影结果为中段结石.结论应用腔内超声诊断输尿管下段结石具有快捷、方便、准确率高等优点,值得推广应用.     

The incidence and implications of haematuria in renal colic

The aim of the study was to investigate the incidence of haematuria in patients presenting to the emergency department with renal colic, subsequently proven to be due to renal or ureteric calculus. Of 461 files reviewed, 239 satisfied the study criteria. Twenty two of these (9.2%) had no haematuria. Injectable narcotic analgesic was required in 203 of 239 cases whilst the remaining 36 patients received oral analgesic. Analysis of data from the study group as well as two other groups selected from the rejected files showed that the incidence of haematuria was the highest (91%) when patients presented with acute renal colic requiring injectable narcotic analgesic (active state) and was the lowest (47%) for patients admitted for elective management of calculi (quiescent state). Emergency intravenous urogram should be performed in patients presenting with suspected renal colic without haematuria.     

体外冲击波碎石治疗输尿管结石所致肾绞痛220例

目的分析220例输尿管结石所致肾绞痛ESWL治疗效果,及施行外科干预治疗的原因。方法对220例输尿管结石所致肾绞痛患者行ESWL治疗和随访。结果一次性碎石成功率为85%(187/220),12例行二次碎石,16例行输尿管口扩张剪开术,3例行输尿管切开取石术。结论应用ESWL治疗输尿管结石所致肾绞痛疗效确切,可靠,是首选的治疗方法。     

输尿管结石126例临床X线分析

目的：探讨输尿管髂段结石移位和柱状形结石对肾功能的影响。材料与方法：回顾性分析经手术和临床X线确诊的输尿管结石126例;全部病例先用常规法IVP,27例加照延迟片。继用大剂量法6例,逆行造影24例,肾盂穿刺造影1例。结果：阳性结石104例,阴性结石22例。4例髂段结石移至骶髂关节外侧,距体中线约7cm～9cm。柱状形结石与圆形、梭形结石引起重度肾积水和不显影的对比,经X2检验,P值分别＜0．01和＜0．05,具有显著性差异。结论：腹部输尿管在结石引起慢性梗阻致重度扩张和重度肾积水时,易受牵拉、移位,在临床X线诊断工作中应引起注意。柱状形结石对肾功能影响最为严重,且不论其直径大小,保守治疗难以奏效,宜特别谨慎。     

输尿管镜下碎石术治疗输尿管结石并发肾绞痛80例

目的探讨输尿管镜下碎石术治疗输尿管结石并发肾绞痛的疗效。方法对80例因输尿管结石并发肾绞痛患者，采用输尿管镜下碎石术。结果1例因结石上移至肾盂，1例因输尿管下段狭窄使输尿管镜无法到达结石部位手术失败，其余78例均碎石成功，术后当天肾绞痛缓解，碎石手术成功率和术后肾绞痛缓解率均为97．5％。结论输尿管镜下碎石术治疗输尿管结石及其引起的肾绞痛，是一种安全、有效的方法。     

妊娠急诊行输尿管镜碎石19例围手术期护理体会

目的:探讨妊娠合并输尿管结石致肾绞痛患者行输尿管镜碎石的围手术期护理。方法:回顾性分析我院19例妊娠合并输尿管结石,急诊行输尿管镜碎石(反复肾绞痛患者)的治疗及护理。结果:本组病例均行输尿管镜气压弹道碎石术,术后无肾绞痛发作,无并发症发生,术后4～7d康复出院。结论:严密观察病情、胎动和胎心音的变化,周密的围手术期护理,对减少并发症发生,减轻患者痛苦,保证母婴健康,提高患者生活质量有着重要的意义。