Cass A S, Lee J Y, Aliabadi H
Midwest Urologic Stone Unit, Hennepin County Medical Center, St. Paul, Minnesota.
J Urol. 1992 Sep;148(3 Pt 2):1123-5. doi: 10.1016/s0022-5347(17)36837-4.
A total of 12 patients with urinary diversions had calculi in 15 kidneys managed initially by extracorporeal shock wave lithotripsy (ESWL) in 12 kidneys and percutaneous nephrolithotripsy in 3. After 15 treatments with ESWL only 3 of the 12 kidneys (25%) became stone-free. Endoscopic procedures were used in 5 kidneys with fragments remaining after ESWL, and comprised percutaneous ultrasound lithotripsy in 2 and transstomal retrograde manipulations in 3. The 3 initial and 5 subsequent endoscopic procedures resulted in 6 of the 8 kidneys (75%) being stone-free. The poor results with ESWL are due to preexisting dilated upper urinary tracts and to immobility in obese myelomeningocele patients. Endoscopic procedures are the preferred method of treatment in these patients.
共有12例尿路改道患者的15个肾脏出现结石，最初对其中12个肾脏采用体外冲击波碎石术（ESWL）治疗，3个肾脏采用经皮肾镜取石术治疗。经15次ESWL治疗后，12个肾脏中只有3个（25%）结石清除。对于ESWL后仍有结石碎片残留的5个肾脏，采用了内镜手术，其中2个采用经皮超声碎石术，3个采用经造口逆行操作。最初的3次及随后的5次内镜手术使8个肾脏中的6个（75%）结石清除。ESWL效果不佳是由于存在预先扩张的上尿路以及肥胖型脊髓脊膜膨出患者活动不便。内镜手术是这些患者的首选治疗方法。
