Küpeli B, Tunç L, Alkibay T, Karaoglan U, Bozkirli I
Department of Urology, School of Medicine, Gazi University, M. Kemal Mah./Eskisehir Yolu, Ankara, Turkey.
BJU Int. 2001 Dec;88(9):854-7. doi: 10.1046/j.1464-4096.2001.01275.x.
To determine the effect of variations in pelvicalyceal volume on the results of extracorporeal shock wave lithotripsy (ESWL) and the relationship of stone load to estimated pelvicalyceal volume in patients with renal pelvic stones.
In all, 204 patients with renal pelvic stones were treated primarily by ESWL. Exclusion criteria were radiolucent stones, dilatation of the renal collecting system, JJ stent insertion before ESWL and an inadequate follow-up. The surface area of the stones and the renal collecting system were measured using a grid of 1 mm2 divisions. The pelvicalyceal volume was calculated as 0.6 (area)1.27. To evaluate the treatment results a pelvicalyceal stone load (PSL) index, describing the relationship of stone load to total estimated pelvicalyceal volume, was defined as stone volume/renal collecting system volume.
The mean (range) pelvicalyceal volume of the patients was 13.24 (4.12-28.47) mm3 and the mean PSL index was 26.2%. The cumulative success rates according to the PSL decreased from 97% to 90% with increasing PSL, but remained at > 95% in patients with a PSL index of < 50%. In all, 184 sessions were applied and the session/patient ratio increased from 1.41 to 3.0 with increasing PSL. Complications were acute pyelonephritis in three and steinstrasse in five patients.
The PSL index appears to be a more accurate and reproducible method for predicting the outcome of ESWL, and has the advantage of considering the effect of pelvicalyceal anatomy.
确定肾盂肾盏容积变化对体外冲击波碎石术（ESWL）结果的影响，以及肾盂结石患者结石负荷与估计肾盂肾盏容积之间的关系。
总共204例肾盂结石患者主要接受ESWL治疗。排除标准为阴性结石、肾集合系统扩张、ESWL前插入双J支架以及随访不充分。使用1mm²方格测量结石和肾集合系统的表面积。肾盂肾盏容积计算为0.6×（面积）^1.27。为评估治疗结果，定义了一个肾盂结石负荷（PSL）指数，用于描述结石负荷与估计的肾盂肾盏总体积之间的关系，即结石体积/肾集合系统体积。
患者的平均（范围）肾盂肾盏容积为13.24（4.12 - 28.47）mm³，平均PSL指数为26.2%。随着PSL增加，根据PSL的累积成功率从97%降至90%，但PSL指数<50%的患者累积成功率仍>95%。总共进行了184次治疗，随着PSL增加，治疗次数/患者比例从1.41增加到3.0。并发症包括3例急性肾盂肾炎和5例石街形成。
PSL指数似乎是一种更准确且可重复的预测ESWL结果的方法，并且具有考虑肾盂肾盏解剖结构影响的优势。
