妊娠期肾绞痛的临床特点及诊治分析

目的观察妊娠期肾绞痛的临床特点,探讨妊娠期肾绞痛有效、安全的诊断和治疗方法。方法回顾性分析2006年6月—2011年3月在我院就诊的46例妊娠期肾绞痛患者的临床资料,给予所有患者对症保守治疗,对于保守治疗无效者采取外科治疗。结果本组46例患者先行保守治疗,其中37例治疗有效,23例排出结石;9例经保守治疗无效,行输尿管镜下内支架管置入术,患者疼痛迅速缓解。所有患者产后3个月行彩色多普勒超声复查显示患肾恢复良好、积水减少或消失,仅3例有轻度积水。结论对于妊娠期肾绞痛的患者,泌尿系结石多见,彩色多普勒超声检查为首选,磁共振泌尿系水成像检查是理想的检查方法。妊娠期肾绞痛绝大部分保守治疗有效,对保守治疗无效的患者在局麻下应用输尿管镜下置入内支架管能有效缓解肾绞痛,是安全和有效的外科治疗方法。

Clinical Observation of Diagnosis and Treatment of Renal Colic During Pregnancy

Objective To analyze the clinical features of renal colic in pregnant patients and to evaluate efficacious and safe methods for the diagnosis and treatment of renal colic in pregnancy.Methods Clinical data of 46 pregnant patients with renal colic admitted to our hospital from June 2006 to March 2011 were retrospectively analyzed.All patients were given symptomatic conservative treatment,and surgical treatment was given to those who failed to respond to conservative treatment.Results All patients were treated by conservative therapy in the first place.37 cases had remarkably effective outcome,23 cases had expulsion of stones.9 cases failed to respond to conservative therapy,but their pain was relieved after the placement of uretal stent with ureteroscopic.All patients were reexamined by color Doppler echocardiography three month after childbirth.The renal recovery was obvious in all cases and hydronephrosis was reduced or disappeared.Only 3 cases had mild hydronephrosis.Conclusion Urinary calculus is commonly seen among pregnant patients with renal colic.Color Doppler echocardiography is the first choice in the examination of the disease,and urinary system magnetic nuclear Resonance Water Imaging(MRU) is also an ideal method.Conservative therapy is effective for most pregnant patients with renal colic,but relief of pain can be achieved after the placement of uretal stent with ureteroscopic,which is a safe and effective surgical therapy.