收稿日期：2023-03-03 接受日期：2023-03-03 出版日期：2023-03-03 发布日期：2023-03-03
通讯作者： 李斌,山东省青岛大学附属医院 泌尿外科，青岛 266003
作者简介： 班自芹,山东省青岛市市南区珠海路街道海口路社区卫生服务中心，青岛 266075 . 刘璐,山东省潍坊市益都中心医院 胸外科，山东 潍坊 262550 . 李斌,山东省青岛大学附属医院 泌尿外科，青岛 266003 .
基金资助：，项目负责人： 李斌
中图分类号：R691.4
文献标识码：A
文章编号：1674-7410(2022)01-0066-03
DOI：10.3969/j.issn.1674-7410.2022.01.017
关键词：
摘要：妊娠期输尿管结石可能诱发急性肾绞痛、泌尿系感染甚至脓毒血症，诊疗时不仅需要保证孕妇的生命安 全，还要考虑诊治过程对胎儿健康的影响，需要泌尿外科、产科、放射科、麻醉科多学科协作，相当谨慎和棘 手，本文将国内外学者在妊娠期输尿管结石的诊断进展进行综述。
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班自芹,刘璐,李斌. 妊娠期输尿管结石诊断进展[J]. 泌尿外科杂志（电子版）,2022,14(1):66-68. DOI:10.3969/j.issn.1674-7410.2022.01.017.
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妊娠期泌尿系结石发生率为5/1 000~8/1 000[1- 2] 。 其中妊娠期输尿管结石可能诱发急性肾绞痛、泌尿 系感染甚至脓毒血症，引起子宫收缩、流产等并发 症，临床医生不仅需要保证孕妇的生命安全，还要 考虑诊治过程对胎儿健康的影响，相当谨慎和棘 手[3-4] 。本文将国内外学者在妊娠期输尿管结石的诊 断进展作一综述。
1 妊娠期易发泌尿系结石的原因
2 妊娠期输尿管结石的诊断
2.1 彩超
2.1.1 肾盂积水程度
2.1.2 肾动脉阻力指数变化
2.1.3 经阴道超声
2.2 CT
2.3 X线和静脉肾盂造影 （intravenous pyelography， IVP）
2.4 磁共振尿路造影 （magnetic resonance urography， MRU）
3 小结
3 小结
妊娠期合并输尿管结石可能导致孕妇及胎儿出 现严重并发症，多需临床医生尽快作出明确诊断与 处理。在诊治过程中，需要考虑对胎儿健康的影 响，无放射风险的彩超被公认为首选的检查方式， 必要时可结合经腹及经阴彩超来间接诊断。CT由于 存在放射性，鉴于我国目前医疗环境及医患关系的 复杂性，除非疾病严重影响患者生命安全，在优先 保证患者生命安全前提下，充分告知患者及家属可 能造成的后果，取得签字同意后方可进行该项检 查。MRU 没有电离辐射，已被证明是相对安全的， 可间接发现输尿管结石的证据。对妊娠合并输尿管 结石的患者，需要多学科协作才能准确地做出诊 断，并与患者及家属积极沟通，进行及时、有效的 治疗。
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