Elsobky E, Sheir K Z, Madbouly K, Mokhtar A A
Mansoura Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
BJU Int. 2000 Nov;86(7):851-6. doi: 10.1046/j.1464-410x.2000.00899.x.
To assess the value of extracorporeal shock wave lithotripsy (ESWL) in treating paediatric urolithiasis, and to determine factors that may affect the results.
Using two types of lithotripters (MFL 5000, Dornier MedTech GmbH, Germany, and the Echolith, Toshiba Medical Systems, Japan), 148 children and adolescents (mean age 11.2 years, SD 4.7, range 1-18) were treated for urinary stones. Of these, 137 patients had renal stones and 11 had ureteric stones. The respective mean (SD) stone width and length were 10.2 (4.1) and 12.9 (5.6) mm for renal stones and 7.6 (2.7) and 9.1 (2.7) mm for ureteric stones. The patients were assessed 3 months after treatment and the results compared using the chi-square test to detect factors that might be associated with the stone-free rate.
For those with renal stones, the overall stone-free rate was 86% and the re-treatment rate 64%. The only significant factor associated with the stone-free rate was the transverse diameter of the stone (P = 0.012); there was no significant effect of the type of lithotripter but there was a significant difference in re-treatment rate (P = 0.016) in favour of the MFL 5000. All those with ureteric stones were rendered stone-free and only four required re-treatment. Only one child among those with renal stones developed steinstrasse; this was managed by ureteroscopy and otherwise no other complications were recorded in either group.
ESWL is a safe and effective treatment for paediatric urolithiasis. The stone-free rate is influenced significantly by stone size. The re-treatment rate differed significantly between the electrohydraulic and piezoelectric lithotripters, but the stone-free rate did not.
评估体外冲击波碎石术（ESWL）治疗小儿尿路结石的价值，并确定可能影响治疗结果的因素。
使用两种碎石机（德国多尼尔医疗技术有限公司的MFL 5000和日本东芝医疗系统公司的Echolith），对148例儿童和青少年（平均年龄11.2岁，标准差4.7，年龄范围1 - 18岁）进行尿路结石治疗。其中，137例患者患有肾结石，11例患有输尿管结石。肾结石的平均（标准差）结石宽度和长度分别为10.2（4.1）毫米和12.9（5.6）毫米，输尿管结石的平均（标准差）结石宽度和长度分别为7.6（2.7）毫米和9.1（2.7）毫米。治疗3个月后对患者进行评估，并使用卡方检验比较结果，以检测可能与结石清除率相关的因素。
对于肾结石患者，总体结石清除率为86%，再次治疗率为64%。与结石清除率相关的唯一显著因素是结石的横向直径（P = 0.012）；碎石机类型对结石清除率无显著影响，但在再次治疗率方面存在显著差异（P = 0.016），MFL 5000更具优势。所有输尿管结石患者均实现结石清除，只有4例需要再次治疗。肾结石患者中只有1例出现石街；通过输尿管镜检查进行了处理，两组均未记录到其他并发症。
ESWL是治疗小儿尿路结石的一种安全有效的方法。结石清除率受结石大小的显著影响。电液压碎石机和压电碎石机的再次治疗率存在显著差异，但结石清除率无差异。
