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妊娠合并肾结石的治疗方法、危险因素及围产期结局:一项单中心回顾性研究

Treatment Approaches, Risk Factors, and Perinatal Outcomes in Pregnancy Complicated by Nephrolithiasis: A Single-Center Retrospective Study.

作者信息

Chen Xian, Ni Rui-Lan, Lv Bing-Qing

机构信息

Department of Gynecology and Obstetrics, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, 350000, People's Republic of China.

出版信息

Int J Womens Health. 2025 Mar 7;17:673-680. doi: 10.2147/IJWH.S509407. eCollection 2025.

Abstract

OBJECTIVE

Nephrolithiasis is a common non-obstetric cause of abdominal pain during pregnancy. This study aimed to investigate various treatment approaches for nephrolithiasis during pregnancy, identify the associated risk factors, and evaluate perinatal outcomes.

METHODS

A retrospective analysis was conducted on the clinical treatment of 208 patients diagnosed with nephrolithiasis during pregnancy, admitted to Fujian Maternal and Child Health Hospital, China, between January 2020 and December 2023. Data on maternal demographic characteristics were extracted to analyze the risk factors associated with nephrolithiasis in pregnancy and to explore correlations with specific treatment modalities through Chi-squared test, Fisher's exact probability method, and univariate logistic regression analysis.

RESULTS

The study included 208 patients, of whom 130 were managed with observation, 46 patients received symptomatic treatment with appropriate medications, and 32 patients underwent surgical intervention, specifically ureteral stent placement. Statistical analysis identified that the timing of symptom onset, presence of clinical symptoms, dilatation of ureter, location of dilation, stone size, and abnormalities in routine urine tests were significant risk factors influencing treatment modalities for nephrolithiasis in pregnancy. A statistically significant difference was observed in treatment modalities among patients with nephrolithiasis complicated by hypertensive disorders. In contrast, patients with combined hyperglycemic disorders exhibited no statistically significant difference among the different treatment modalities.

CONCLUSION

Effective and timely management of nephrolithiasis in pregnancy, guided by patient-specific clinical characteristics, is essential for optimizing maternal and perinatal outcomes.

摘要

目的

肾结石是妊娠期腹痛常见的非产科病因。本研究旨在探讨妊娠期肾结石的各种治疗方法,确定相关危险因素,并评估围产期结局。

方法

对2020年1月至2023年12月在中国福建省妇幼保健院住院的208例诊断为妊娠期肾结石的患者的临床治疗进行回顾性分析。提取产妇人口统计学特征数据,通过卡方检验、Fisher确切概率法和单因素逻辑回归分析,分析妊娠期肾结石的相关危险因素,并探讨与特定治疗方式的相关性。

结果

该研究纳入208例患者,其中130例采取观察治疗,46例接受适当药物对症治疗,32例接受手术干预,具体为输尿管支架置入术。统计分析确定,症状发作时间、临床症状的存在、输尿管扩张、扩张部位、结石大小和尿常规异常是影响妊娠期肾结石治疗方式的重要危险因素。妊娠期肾结石合并高血压疾病的患者在治疗方式上存在统计学显著差异。相比之下,合并高血糖疾病的患者在不同治疗方式之间未表现出统计学显著差异。

结论

根据患者具体临床特征进行有效、及时的妊娠期肾结石管理,对于优化孕产妇和围产期结局至关重要。

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本文引用的文献

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Maternal and fetal outcomes of urolithiasis: A retrospective cohort study.尿路结石的母婴结局:一项回顾性队列研究。
J Gynecol Obstet Hum Reprod. 2021 Nov;50(9):102161. doi: 10.1016/j.jogoh.2021.102161. Epub 2021 May 10.
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Obstetric outcomes of pregnancy complicated by urolithiasis: a retrospective cohort study.
J Perinat Med. 2020 Aug 18;49(1):54-59. doi: 10.1515/jpm-2020-0199.

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