中国全科医学 ›› 2023, Vol. 26 ›› Issue (05): 519-524.DOI: 10.12114/j.issn.1007-9572.2022.0569

所属专题: 指南/共识最新文章合集

• 指南解读 •    下一篇

美国2021版《妊娠期肾结石诊治-单中心多学科指南》解读——提高临床诊断能力,加强多学科协作管理

梁普照1, 田振涛1,*(), 吴钰仪2   

  1. 1.300381 天津市,天津中医药大学第一附属医院泌尿外科 国家中医针灸临床医学研究中心
    2.300381 天津市,天津中医药大学第一附属医院儿科 国家中医针灸临床医学研究中心
  • 收稿日期:2022-06-19 修回日期:2022-09-05 出版日期:2023-02-15 发布日期:2022-09-29
  • 通讯作者: 田振涛

  • 作者贡献:梁普照进行文章的构思及设计,文章的可行性分析,文献/资料收集、整理,撰写论文;梁普照、吴钰仪进行论文及英文的修订;田振涛负责文章的质量把控及审校,对文章整体负责,监督管理。
  • 基金资助:
    天津市卫计委中医中西医结合课题(13063)

Interpretation of the Management of Nephrolithiasis in Pregnancy: Multi-disciplinary Guidelines from an Academic Medical Center: Improving the Diagnostic and Therapeutic Capacity, and Strengthening Multi-disciplinary Collaborative Management

LIANG Puzhao1, TIAN Zhentao1,*(), WU Yuyi2   

  1. 1. Department of Urology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
    2. Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
  • Received:2022-06-19 Revised:2022-09-05 Published:2023-02-15 Online:2022-09-29
  • Contact: TIAN Zhentao

摘要: 妊娠期肾结石是妊娠期患者非产科因素住院的常见病因,容易出现疼痛、恶心、呕吐、肾功能下降、泌尿道感染等并发症,处理不当会导致流产、早产等不良妊娠结局。美国医学中心多学科联合发布《妊娠期肾结石诊治-单中心多学科指南》,以规范妊娠期肾结石的诊治。本指南共形成10个指南推荐意见,其中4个用于指导诊断和影像学检查,6个用于指导临床治疗。值得关注的是,与国内指南相比,该指南提供了循证依据,证实了妊娠期使用低剂量CT平扫的安全性、有效性,并可以在患者病情变化且诊断不明确时优先使用,本文就以上内容对该指南展开深度解读。

关键词: 肾结石, 妊娠期肾结石, 诊断, 多学科协作, 指南, 美国, 解读

Abstract:

Nephrolithiasis in pregnancy is a common non-obstetric indication for hospital admission in obstetric patients, which is often associated with pain, nausea, vomiting, decreased renal function, urinary infection and other symptoms, and improper treatment for which will lead to abortion, premature delivery and other adverse pregnancy outcomes. In response, a multi-disciplinary team from a single academic medical center in the United States was assembled to create the management of nephrolithiasis in pregnancy: multi-disciplinary guidelines from an academic medical center to standardize the care for obstetric patients presenting with suspected nephrolithiasis. A total of 10 guideline statements were constructed, including four for guiding diagnosis and imaging, and six for guiding clinical treatment. It is noteworthy that compared with relevant Chinese guidelines, the guidelines provide practice-based evidence that proves the safety and effectiveness of low-dose non-contrast CT scan preferably used when condition changes and diagnostic uncertainty exists. This paper offers an in-depth interpretation of the above-mentioned contents in the guidelines.

Key words: Kidney calculi, Nephrolithiasis, pregnancy, Diagnosis, Multi-disciplinary team, Guidebooks, United States, Interpretation