Skolarikos Andreas, Alivizatos Gerasimos, de la Rosette Jean
Urology Department, Athens Medical School, Sismanoglio Hospital, Athens, Greece.
Eur Urol. 2006 Nov;50(5):981-90; discussion 990. doi: 10.1016/j.eururo.2006.01.045. Epub 2006 Feb 7.
We review the pathophysiology and possible prevention measures of complications after extracorporeal shock wave lithotripsy (ESWL).
A literature search was performed with the Medline database on ESWL between 1980 and 2004.
ESWL application has been intuitively connected to complications. These are related mostly to residual stone fragments, infections, and effects on tissues such as urinary, gastrointestinal, cardiovascular, genital, and reproductive systems. Recognition of ESWL limitations, use of alternative therapies, correction of pre-existing renal or systemic disease, treatment of urinary tract infection, use of prophylactic antibiotics, and improvement of ESWL efficacy are the most important measures of prevention. Decrease of shock wave number, rate and energy, use of two shock-wave tubes simultaneously, and delivery of two shock waves at carefully timed close intervals improve ESWL efficacy and safety.
ESWL is a safe method to treat stones when proper indications are followed. The need for well-designed prospective randomised trials on aetiology and prevention of its complications arises through the literature review.
我们回顾体外冲击波碎石术（ESWL）后并发症的病理生理学及可能的预防措施。
利用Medline数据库对1980年至2004年间关于ESWL的文献进行检索。
ESWL的应用一直被直观地认为与并发症有关。这些并发症大多与残留结石碎片、感染以及对泌尿系统、胃肠道、心血管系统、生殖系统等组织的影响有关。认识ESWL的局限性、使用替代疗法、纠正既往存在的肾脏或全身性疾病、治疗尿路感染、使用预防性抗生素以及提高ESWL疗效是最重要的预防措施。减少冲击波次数、频率和能量，同时使用两个冲击波管，并在精心设定的紧密时间间隔内发射两个冲击波，可提高ESWL的疗效和安全性。
当遵循适当的适应证时，ESWL是一种治疗结石的安全方法。通过文献回顾，有必要针对其并发症的病因和预防开展精心设计的前瞻性随机试验。
