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体外冲击波碎石术治疗上尿路结石的结果

Results of extracorporeal shock wave lithotripsy for the treatment of upper urinary tract stones.

作者信息

Tomomasa Hiroshi, Kaneko Shoji, Ogawa Kazue, Satoh Satoshi, Muramatsu Hiroshi, Satoh Mika, Umeda Takashi, Okada Eiko, Iizumi Tatsuo

机构信息

Department of Urology, Ageo Central General Hospital.

出版信息

Hinyokika Kiyo. 2007 Nov;53(11):771-6.

Abstract

The treatment results of 697 renal units in 687 patients treated for upper urinary tract stones using a Piezolith 2500 at the Ageo Central General Hospital during the 5-year period between August 1999 and July 2004 were analyzed. The stone-free rate and the success rate were calculated according to the stone size and location. Univariate and multivariate logistic regression analyses were performed to estimate the effect of the patient age, sex, affected side, stone location and stone size on the stone-free rate and the success rate. Overall, the stone-free rate and the success rate at 3 months after treatment were 82.6% and 91.9%, respectively. The stone-free rates in renal and ureteral stones were 60.5% and 88.7%, respectively. The success rates for renal and ureteral stones were 93.6% and 91.6%, respectively. In a univariate logistic regression analysis, patient age and stone size were significant negative factors for both the stone-free rate and the success rate and the stone location in ureter was a significant positive factor only for the stone-free rate. In a multivariate analysis, stone location in the ureter had a positive effect on the stone-free rate, although a negative effect on the success rate. Extracorporeal shock wave lithotripsy for upper urinary tract stones was an effective and safe treatment modality. However, if pre-treatment factors indicate unfavorable outcome, the other treatment options should be considered for the first line therapy.

摘要

对1999年8月至2004年7月期间在阿戈中央综合医院使用Piezolith 2500治疗上尿路结石的687例患者的697个肾单位的治疗结果进行了分析。根据结石大小和位置计算无结石率和成功率。进行单因素和多因素逻辑回归分析,以评估患者年龄、性别、患侧、结石位置和结石大小对无结石率和成功率的影响。总体而言,治疗后3个月的无结石率和成功率分别为82.6%和91.9%。肾结石和输尿管结石的无结石率分别为60.5%和88.7%。肾结石和输尿管结石的成功率分别为93.6%和91.6%。在单因素逻辑回归分析中,患者年龄和结石大小是无结石率和成功率的显著负性因素,输尿管结石位置仅是无结石率的显著正性因素。在多因素分析中,输尿管结石位置对无结石率有正性影响,尽管对成功率有负性影响。上尿路结石的体外冲击波碎石术是一种有效且安全的治疗方式。然而,如果治疗前因素表明预后不佳,则应考虑将其他治疗选择作为一线治疗方法。

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