妊娠期肾绞痛的临床诊治体会

目的探讨妊娠期肾绞痛的临床诊治方法及疗效。方法回顾性分析25例妊娠期肾绞痛患者的临床资料。结果 25例患者平均年龄26岁,22例为初产妇,3例经产妇,右侧12例,左侧13例。临床表现为腰腹部疼痛。B超检查发现结石23例,未发现结石2例,患侧肾脏均轻度-中度积水;经保守治疗后,21例患者肾绞痛缓解,17例自行结石排出;2例行膀胱镜下双J管置入内引流,疼痛缓解,结石排出;1例行输尿管镜下气压弹道碎石成功。1例选择终止妊娠后体外碎石治疗成功,其余24例孕妇均无产科并发症。结论妊娠期肾绞痛的诊断首选超声检查,病因多为上尿路结石,保守治疗对绝大多数病例安全有效。腔内治疗亦安全有效。

Diagnosis and Treatment of Renal Colic during Pregnancy

Objective To evaluate the effect of the diagnosis and treatment of renal colic in pregnant woman.Methods The clinical data of 25 pregnant women complicating renal colic were analyzed retrospectively.Results The average age is 26 years,22 patients are primiparous women,3 patients are multipara.Of the 25 patients,12 were on the right side and 13 were on the left.Flank pain was the most common clinical presentation.Diagnostic imaging calculi were visualized in 23 of 25 ultrasonographic examinations,2 cases were invisibled.Nephrocolic side kidney all presented light to midrange hydrops.Management was initially conservative in all patients,resulted in resolution of symptoms in 21 women and 17 spontaneously discharged the stone.Double-J catheter was indwelt for drainage in 2 cases through cystoscope,renal colic relieved immediately,then ureteral calculus were spontaneous eliminated.1 case with calculi received ureteroscope lithotripsy successfully.1 case selected termination of pregnancy and received extracorporeal shock-wave lithotripsy successfully.There is no obstetrical complications occurred among the rest 24 pregnant women.Conclusion Ultrasonography is the primary diagnostic tool for pregnant women complicating renal colic.The common cause is urolithiasis.Conservative treatment is the first safe effective choice for most patients.If conservative treatment fails,intracavitary therapy is another safe effective choice.