The Diagnosis And Treatment Of Upper Urinary Tract Calculi In Pregnant Women

Objective: About clinical diagnosis and treatment of upper urinary tract calculicomplicating pregnancy methods prescriptive guidance is issued.Study on upper urinarytract calculi complicating pregnancy outcomes focused on one specific pros and cons oftesting or treatment for the disease effects.Produces a majority of clinical medicalpersonnel were based solely on personal experience to diagnosis and treatment, maternaland fetal safety could not be guaranteed.Through the undergraduate clinical summary ofadmitted patients in the last decade to explore the pathogenesis of upper urinary tractcalculi complicating pregnancy, clinical manifestations, diagnosis, and treatment, hopingfor the clinical field in the process of diagnosis and treatment with scientificallytheoretical basis.Methods: Retrospective analysis, summarize the urology admitted between January2004-December2012for101cases of3-9months in patients with upper urinary tractcalculi in pregnancy medical history materials.These patients using conventionalultrasound, color Doppler ultrasound, respectively, single photon emission scintigraphy,magnetic resonance urography (MRU) to check.Diagnostic clear down, waiting for theobservation, drug treatment, Ureteral stent (URS), percutaneous renal puncture andfistulation (PCN), gravel stone by ureteroscope (URL) and the opening up ofcomprehensive treatment measures, such as stone, by obstetrician and telephonefollow-up after treatment in patients with symptomatic improvement after the treatment,complications, postoperative residual stones and delivery conditions.Result: Simple ureteral calculi: report of63cases, simple kidney stones in33cases,combined with kidney stones5cases with Ureteral calculi. By b-mode and Doppler andcolour Doppler ultrasound diagnosis of89patients, diagnosis and effective rate of88.12%.Evaluation of MR urography (MRU) with7confirmed cases, single photon Imaging in5patients with confirmed cases.8patients with asymptomatic by waiting forthe observation was not taking medication,2the stones out of the body duringpregnancy.After conservative treatment for93cases of drug use in patients with simplesymptoms under control and a smooth delivery of69cases, drug treatment effectivenessis74.2%.24cases of surgical treatment for drug use in selected is not valid.In the surgicaltreatment of17patients with Ureteral stent (URS),3routine ureteroscopic lithotripsystone (URL),4cases of percutaneous renal puncture and fistulation (PCN), including3cases with simple fistulation,1row because of lower ureteral stricture after Ostomysurgery recurrent infections and eventually chose to open surgery.All surgical patientsdue to blood transfusion-free, none in obstetrics and telephone follow-up prenatalcomplications such as termination of pregnancy and maternal mortality.Conclusions: Ultrasonography for the diagnosis of upper urinary tract calculicomplicating pregnancy first choice secondary renal vascular resistance index and thelike.If the diagnosis is still difficult, renal or MRU can be selected to prohibit the use ofradiological examination.After the diagnosis clearly, if there is no hydronephrosis, sepsis,or renal impairment, conservative treatment should be preferred, include bed rest, plentyof fluids, symptomatic treatment such as muscular spasm and pain.If further deteriorationof renal function in patients with non-surgical treatment is not valid, required surgicalintervention.URS as a preferred method of surgical intervention;PCN as a second choice,applied to calculi obstruction causing acute urinary tract infection or in patients withimpaired renal function;URL removal rates, has proven to be an effective method ofdiagnosis and treatment, mainly applied to lower ureter calculus;Need to row the renalpelvis or ureter lithotomy;Percutaneous nephrolithotomy and extracorporeal shock wavelithotripsy is not permitted.