Ng C F, McLornan L, Thompson T J, Tolley D A
Scottish Lithotriptor Centre, Western General Hospital, Edinburgh, United Kingdom.
J Urol. 2004 Nov;172(5 Pt 1):1887-91. doi: 10.1097/01.ju.0000142730.60583.7a.
The Piezolith 3000 (Richard Wolf, Knittlingen, Germany) is the newest piezoelectric lithotriptor. Using a matched pair analysis model we compared treatment outcomes of this machine with those of an older generation Piezolith 2300 lithotriptor (Richard Wolf).
Patients with solitary, radio-opaque urinary calculi undergoing primary lithotripsy using the Piezolith 3000 were identified. All patients had a 3-month followup. These patients were matched with those from our database treated between 1992 and 1999 with a Piezolith 2300. Patients were initially matched for gender, side and site of the stone. For stones other than those in the lower calix and lower ureter, matching was performed for size in terms of maximum and minimum diameter of the index stone. Additional anatomical factors of caliceal pelvic height and vertical distance of the lower ureteral stone from pubic symphysis were also measured. Thereafter stones with size +/- 1 mm of the index stone were selected and the stone with the best matched anatomical factors was chosen. The initial stone fragmentation rate and stone-free rates at 3 months in the matched pairs were then compared.
A total of 25 matched pairs were found between October 2002 and December 2002. There was no statistical difference between the initial fragmentation rate for the Piezolith 3000 (68%) and the Piezolith 2300 (84%, McNemar's test p = 0.388). The stone-free rate at 3 months for the Piezolith 3000 and the Piezolith 2300 were 36% and 48%, respectively, again with no statistical difference (McNemar's test p = 0.581).
Despite significant design changes and technical modifications, the new piezoelectric lithotriptor does not appear to provide a better treatment outcome than the older generation machine.
Piezolith 3000（德国克尼特林根的理查德·沃尔夫公司）是最新的压电碎石机。我们使用配对分析模型，将该机器的治疗结果与上一代Piezolith 2300碎石机（理查德·沃尔夫公司）的治疗结果进行了比较。
确定使用Piezolith 3000进行初次碎石的孤立性、不透X线的尿路结石患者。所有患者均进行了3个月的随访。这些患者与我们数据库中1992年至1999年使用Piezolith 2300治疗的患者进行配对。患者最初按照性别、结石所在侧和部位进行匹配。对于肾下盏和输尿管下段以外的结石，按照结石最大和最小直径的尺寸进行匹配。还测量了肾盂高度和输尿管下段结石距耻骨联合的垂直距离等其他解剖学因素。此后，选择尺寸与索引结石相差±1mm的结石，并选择解剖学因素匹配最佳的结石。然后比较配对组中3个月时的初始结石破碎率和无结石率。
2002年10月至2002年12月共发现25对匹配病例。Piezolith 3000的初始破碎率（68%）与Piezolith 2300的初始破碎率（84%，McNemar检验p = 0.388）之间无统计学差异。Piezolith 3000和Piezolith 2300在3个月时的无结石率分别为36%和48%，同样无统计学差异（McNemar检验p = 0.581）。
尽管有重大的设计变更和技术改进，但新型压电碎石机似乎并未比上一代机器提供更好的治疗效果。
