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目的:探讨妊娠合并输尿管上段结石的诊断和处理方法。方法:采用输尿管镜联合钬激光碎石术治疗妊娠合并输尿管上段结石患者64例。结果:64例患者中,53例一次性碎石取石干净(82.8%),7例结石部分碎片上移入肾盂(10.9%),4例因输尿管扭曲、狭窄等原因上镜失败(3.3%),其中3例置入进口F4.8双J管成功,1例置管失败。1例术后出现先兆流产(1.6%),经处理后缓解。所有患者术后肾绞痛、发热等症状均缓解消失,未发现流产等特殊并发症,疗效满意。结论:输尿管镜联合钬激光碎石术治疗妊娠合并输尿管上段结石一次性碎石率高,并发症少,对孕妇、胎儿影响较小,方法安全有效。
Objective: To investigate the diagnosis and treatment of upper ureteral calculi during pregnancy. Methods: Ureteroscopy combined with holmium laser lithotripsy for the treatment of 64 cases of upper ureteral calculi in pregnancy. Results: Of the 64 patients, 53 of them had a clean lithotripsy (82.8%), 7 of them were moved into the renal pelvis (10.9%), and 4 failed (3.3%) due to ureter distortions and stenosis 3 cases of imported F4.8 double J tube success, 1 case of catheter failure. One patient had threatened abortion (1.6%) after operation and was relieved after treatment. All patients with postoperative renal colic, fever and other symptoms were alleviated and disappeared, did not find any special complications such as abortion, with satisfactory results. Conclusion: Ureteroscopy combined with holmium laser lithotripsy for the treatment of upper ureteral calculi in pregnancy with a high rate of one-time lithotripsy, less complications, less impact on pregnant women, fetus, the method is safe and effective.