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体外冲击波碎石术与腔内泌尿外科技术同台应用:一个可行的概念?

ESWL and endourology on the same table: a feasible concept?

作者信息

Albrecht W, Türk C, Marberger M

机构信息

Department of Urology, Rudolfstiftung, Vienna, Austria.

出版信息

J Lithotr Stone Dis. 1990 Oct;2(4):309-17; discussion 318-9.

Abstract

Within 26 months a total of 4,126 procedures were performed on the ESWL multipurpose table. Forty percent of the procedures were comprised of endourology, 25% functional urinary tract radiology, and 37% ESWL therapy. Biplane fluoroscopy is an extraordinary help for percutaneous interventions. A further advantage is the possibility to perform endourology and ESWL in one session without having to transport the patient. This has facilitated pre- and post-operative ancillary measures in a total of 35.3%. Seventy-six percent of stones greater than 15 mm were managed via indwelling stents. In situ ESWL for ureteral stones has become the therapy of choice in more than 80% of patients due to the availability of radiological localization systems and a complication and failure rate of 20% for the push-and-smash procedure. The multipurpose table is equally successful as the piezoelectric system for ESWL therapy. Drawbacks include operational inconvenience with percutaneous interventions and the necessity to change patient position during ureterorenoscopy and retrograde pyelography. The multipurpose unit used is a valid compromise for ESWL and percutaneous endourology. For purely diagnostic interventions, a standard x-ray table is preferred.

摘要

在26个月内,共在体外冲击波碎石多功能治疗台上进行了4126例手术。其中40%的手术为腔内泌尿外科手术,25%为功能性尿路放射学检查,37%为体外冲击波碎石治疗。双平面荧光透视对经皮介入手术有极大帮助。另一个优点是可以在一次治疗中同时进行腔内泌尿外科手术和体外冲击波碎石,而无需转运患者。这使得术前和术后辅助措施的实施率达到了35.3%。76%的直径大于15毫米的结石通过留置支架进行处理。由于放射定位系统的应用以及“推击粉碎”手术20%的并发症和失败率,输尿管结石原位体外冲击波碎石已成为80%以上患者的首选治疗方法。该多功能治疗台在体外冲击波碎石治疗方面与压电系统同样成功。缺点包括经皮介入操作不便,以及在输尿管肾镜检查和逆行肾盂造影期间需要改变患者体位。所使用的多功能设备是体外冲击波碎石和经皮腔内泌尿外科手术的有效折衷方案。对于单纯的诊断性介入操作,首选标准X光检查台。

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