Andersen J T, Mogensen P
Department of Urology, Hvidovre Hospital, University of Copenhagen, Denmark.
Scand J Urol Nephrol Suppl. 1991;138:19-24.
The first Danish experience with Extracorporeal Shock Wave Lithotripsy (ESWL) using a second generation Lithotriptor (Siemens Lithostar) is reported. 306 patients underwent 392 treatments for 363 stones. There were 339 renal calculi including 5 staghorn calculi and 54 ureteral calculi. Treatments were performed under local analgesia (82%) or epidural or general anesthesia (18%) when invasive procedures had to be done in connection with the treatment. Stone fragmentation was achieved with 2487 +/- 1262 shocks. The first months stone clearance rate was 45%; 26% had fragments less than 6 mm; 29% had residual stones. Corresponding rates after 3 and 6 months were 58%, 24% and 18% and 70%, 21% and 9% respectively. Septicemia occurred in 4 patients and cardial arrhythmia in 34 patients (11%). No serious intra- or perirenal hematomas were registered. In 9% additional procedures were required and 11 patients had residual stones removed at open surgery. The used second generation lithotriptor with X-ray based stone localisation is effective for treatment of both renal calculi and ureteral calculi in situ in all three segments of the ureter.
本文报道了丹麦首次使用第二代碎石机（西门子Lithostar）进行体外冲击波碎石术（ESWL）的经验。306例患者因363块结石接受了392次治疗。其中有339块肾结石，包括5块鹿角形结石和54块输尿管结石。治疗时，82%的患者采用局部镇痛，18%的患者因治疗时需进行侵入性操作而采用硬膜外或全身麻醉。碎石平均使用2487±1262次冲击波。治疗后第一个月结石清除率为45%；26%的患者结石碎片小于6毫米；29%的患者有残余结石。3个月和6个月后的相应比例分别为58%、24%和18%，以及70%、21%和9%。4例患者发生败血症，34例患者（11%）发生心律失常。未记录到严重的肾内或肾周血肿。9%的患者需要额外的治疗，11例患者通过开放手术取出了残余结石。所使用的基于X射线结石定位的第二代碎石机对治疗输尿管三个节段的肾结石和输尿管原位结石均有效。
