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[体外冲击波碎石术(ESWL)治疗孤立性上尿路结石的疗效评估]

[Evaluation of the results of extracorporeal shock-wave lithotripsy (ESWL) for solitary upper urinary tract stone].

作者信息

Wada S, Kishimoto T, Ameno Y, Harima M, Kamizuru M, Iimori H, Kanazawa T, Maekawa T, Asakawa M, Yoshihara H

机构信息

Department of Urology, Osaka City University Medical School.

出版信息

Hinyokika Kiyo. 1991 Dec;37(12):1633-7.

PMID:1785386
Abstract

We performed extracorporeal shock-wave lithotripsy (ESWL) on 1,701 patients in a total of 2,438 sessions using the Dornier kidney lithotriptor Model HM III from July 1985 to the end of June 1990. Among the patients with a solitary stone, 1,200 cases were available for the follow-up study in which the results of ESWL were analyzed according to the location and size of the stone. ESWL performed against stones at pelvis and calyces gave the best results. The results obtained on stones less than 20 mm in diameter were especially favorable with a success rate of 84%. ESWL performed against ureter stones showed poor results with a success rate of 62% for the stones smaller than 20 mm in diameter. We further studied the results of ESWL performed against ureter stones by dividing the patients into three groups: the patients treated in situ, the patients with ureteral stents and the patients with D-J stents. The results for stones larger than 10 mm in diameter were significantly better in the patients with D-J stents than in the patients treated in situ or the patients with ureteral stents. Among the patients treated in situ, the results were significantly worse for impacted stones than for non-impacted stones when the stone size was 10-20 mm in diameter.

摘要

1985年7月至1990年6月底,我们使用多尼尔HM III型肾脏碎石机,对1701例患者共进行了2438次体外冲击波碎石术(ESWL)。在单发结石患者中,有1200例可供随访研究,根据结石的位置和大小对ESWL结果进行了分析。针对肾盂和肾盏结石进行的ESWL效果最佳。对直径小于20mm的结石进行ESWL,效果尤其良好,成功率达84%。针对输尿管结石进行的ESWL效果较差,直径小于20mm的结石成功率为62%。我们进一步将输尿管结石患者分为三组,研究针对输尿管结石进行ESWL的结果:原位治疗患者、放置输尿管支架患者和放置D-J支架患者。对于直径大于10mm的结石,放置D-J支架患者的效果明显优于原位治疗患者或放置输尿管支架患者。在原位治疗患者中,当结石直径为10 - 20mm时,嵌顿性结石的效果明显比非嵌顿性结石差。

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