Page 6 - 2023-05-中国全科医学

2023年2月 第26卷 第5期 http: //www.chinagp.net E-mail: zgqkyx@chinagp.net.cn ·519·

·指南解读·

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

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梁普照 ，田振涛 ，吴钰仪 2 查看原文
【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
【中图分类号】 R 692.4 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2022.0569
梁普照，田振涛，吴钰仪 . 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［J］. 中国全科医学，2023，26（5）：519-524. ［www.chinagp.net］
LIANG P Z，TIAN Z T，WU Y Y. 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［J］. Chinese General Practice，2023，26（5）：519-524.

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
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Collaborative Management LIANG Puzhao ，TIAN Zhentao ，WU Yuyi 2
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
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Corresponding author：TIAN Zhentao，Associate chief physician，Master supervisor；E-mail：zhentaomail@126.com
【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

基金项目：天津市卫计委中医中西医结合课题（13063）
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
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通信作者：田振涛，副主任医师，硕士生导师；E-mail：zhentaomail@126.com
本文数字出版日期：2022-09-29