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目的:探讨妊娠合并肾积水安全有效的治疗方法。方法:回顾分析2008年4月~2013年6月妊娠合并肾积水43例患者的诊疗过程及结果,其中左肾积水7例,右肾积水32例,双肾积水4例;8例患者伴有发热,3例患者合并输尿管结石,25例患者表现为肾绞痛症状。对有肾绞痛症状患者予解痉治疗,泌尿素感染予抗生素,对症状不缓解者予患侧置入双J管。结果:对有症状的妊娠合并肾积水患者给予抗炎、解痉等保守治疗后18例患者症状缓解,7例患者因疼痛不缓解予以膀胱镜留置双J管后症状缓解;3例输尿管结石患者分娩后予以输尿管镜钬激光碎石,1例患者因担心药物对胎儿的不良反应选择终止妊娠。结论:对于有症状的妊娠期肾积水患者首选保守治疗,保守治疗无效可行膀胱镜下双J管置入术可明显缓解症状,对于保障顺利分娩具有重要意义。
Objective: To investigate the safe and effective treatment of pregnancy complicated with hydronephrosis. Methods: The diagnosis and treatment of 43 patients with hydronephrosis during pregnancy from April 2008 to June 2013 were retrospectively analyzed. Among them, 7 cases were hydronephrosis of the left kidney, 32 cases were hydronephrosis of the right kidney and 4 cases were hydronephrosis of the kidney. The patients were accompanied by fever, 3 patients had ureteral calculi, and 25 patients showed symptoms of renal colic. For patients with symptoms of renal colic antispasmodic treatment, urinary tract infection to antibiotics, who did not relieve symptoms to the affected side into double J tube. Results: In symptomatic pregnancy with hydronephrosis in patients with anti-inflammatory, antispasmodic and other conservative treatment of 18 patients with symptoms, 7 patients due to pain did not relieve cystoscopy double J tube after the symptoms were relieved; 3 cases of ureteral stones Patients were given ureteroscopic holmium laser lithotripsy after childbirth, and 1 patient chose termination of pregnancy because of fear of adverse drug reactions to the fetus. CONCLUSIONS: For conservative treatment of patients with symptomatic gestation hydronephrosis, conservative treatment is ineffective via double glaucoma J tube implantation can significantly relieve symptoms, for the protection of smooth delivery of great significance.