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

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