Kavoussi L R, Albala D M, Basler J W, Apte S, Clayman R V
Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri.
J Urol. 1992 Sep;148(3 Pt 2):1069-71. doi: 10.1016/s0022-5347(17)36820-9.
A total of 6 pregnant women with obstructing urinary calculi was managed by percutaneous nephrostomy drainage placed under ultrasound guidance with the patient under local anesthesia. All patients initially had relief of acute obstruction. However, occlusion of the percutaneous nephrostomy tubes with debris necessitated tube changes in 5 of 6 patients. In 2 patients recurrent nephrostomy tube obstruction, fever and pain led to percutaneous stone removal during pregnancy. In the remaining 4 patients the nephrostomy tubes were left indwelling through delivery. During the postpartum period 3 patients successfully underwent ureteroscopic stone extraction and 1 passed the stone spontaneously. Bacteriuria developed in each patient despite the use of preventive antibiotics. All 6 women had uncomplicated vaginal deliveries of healthy newborns and are currently asymptomatic with no evidence of obstruction. Percutaneous drainage of an acutely obstructed kidney in a pregnant woman is an effective temporizing alternative to ureteral stent placement until definitive treatment can be performed.
共有6例患有梗阻性尿路结石的孕妇在局部麻醉下于超声引导下行经皮肾造瘘引流术。所有患者最初急性梗阻症状均得到缓解。然而，6例患者中有5例因肾造瘘管被碎屑堵塞而需要更换造瘘管。2例患者因反复出现肾造瘘管梗阻、发热和疼痛，在孕期接受了经皮取石术。其余4例患者的肾造瘘管留置至分娩。产后，3例患者成功接受了输尿管镜取石术，1例患者结石自行排出。尽管使用了预防性抗生素，每位患者均发生了菌尿。所有6名女性均顺利经阴道分娩出健康新生儿，目前均无症状，无梗阻迹象。在能够进行确定性治疗之前，对孕妇急性梗阻性肾脏进行经皮引流是一种有效的临时替代输尿管支架置入的方法。
