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目的:探讨症状性妊娠期肾积水的腔内微创诊疗方案。方法:对143例保守治疗无效的症状性妊娠期肾积水患者的临床资料进行回顾性分析,65例妊娠期肾积水合并感染患者采用输尿管镜检双J管置入术,78例为妊娠期输尿管结石、肾积水,采用输尿管镜检钬激光碎石术或气压弹道碎石术。结果:143例患者临床症状均明显缓解,65例合并感染患者顺利置入输尿管双J管后症状缓解;78例输管结石患者碎石成功73例(93.6%);143例患者中症状复发者5例(3.5%),双J管下移3例(2.1%),输尿管穿孔2例(1.4%)。结论:在保守治疗无效时,妊娠期肾积水合并感染可采用输尿管双J管置入引流,同时抗感染治疗,效果确切;妊娠期输尿管结石患者采用输尿管镜检钬激光碎石或气压弹道碎石术疗效均安全可靠。
Objective: To investigate the minimally invasive endovascular treatment of symptomatic hydronephrosis during pregnancy. Methods: The clinical data of 143 cases of symptomatic hydronephrosis with conservative treatment were retrospectively analyzed. 65 cases of patients with hydronephrosis during pregnancy were treated by ureteroscopy with double J tube implantation and 78 cases with pregnancy Ureteral calculi, hydronephrosis, ureteroscopic holmium laser lithotripsy or pneumatic lithotripsy. Results: The clinical symptoms of 143 patients were significantly relieved. The symptom relief was achieved in 65 patients with successful infection of ureteral double J tube, 73 patients (93.6%) were successful in 78 patients with ductal stones, and 143 of the 143 patients had recurrence of symptoms 5 cases (3.5%), double J tube down in 3 cases (2.1%), ureter perforation in 2 cases (1.4%). Conclusions: When conservative treatment is not effective, hydronephrosis during pregnancy may be treated with dual J-tube ureteral drainage and anti-infection therapy with definite effect. Patients with ureteral calculi during pregnancy are treated by ureteroscopic holmium laser lithotripsy or pneumatic ballistic crushing Stone surgery are safe and reliable.