Janowitz P, Kratzer W, Wechsler J G, Kuhn K, Janowitz A, Swobodnik W, Ditschuneit H
Abteilung Innere Medizin II, Medizinische Universitätsklinik, Ulm.
Dtsch Med Wochenschr. 1991 Aug 30;116(35):1297-302. doi: 10.1055/s-2008-1063749.
Extracorporeal shockwave lithotripsy (ESWL) with an electrohydraulic system was performed in 124 patients (33 men, 91 women; mean age 50.1 +/- 12.7 years). Sufficient stone fragmentation was achieved in 122 patients (98.3%). ESWL was repeated in 29 patients (23.3%), twice in 7 patients (5.6%). Average shockwave application per patient was 1,441 +/- 414 impulses, at a mean energy of 20.0 +/- 1.6 kV. Mean stone diameter before ESWL was 16.2 +/- 4.2 (7-30) mm, 7.1 +/- 4.1 (0-19) mm after ESWL. Computed tomography, performed immediately after ESWL in 88 patients demonstrated hypodense thickening (3-10 mm) of the gallbladder wall in 28.4% of patients. This was interpreted as wall oedema, reversible in all. One patient had a covered gallbladder rupture and two had biliary pancreatitis. None of the patients required emergency surgery. 93 patients (74.9%) had no stones 12 months later. A high success rate can be achieved if certain criteria are adhered to and suitable patients are selected.
对124例患者(33例男性,91例女性;平均年龄50.1±12.7岁)采用液电系统进行体外冲击波碎石术(ESWL)。122例患者(98.3%)实现了充分的结石破碎。29例患者(23.3%)进行了重复ESWL,7例患者(5.6%)进行了两次重复。每位患者平均冲击波应用次数为1441±414次,平均能量为20.0±1.6 kV。ESWL前结石平均直径为16.2±4.2(7 - 30)mm,ESWL后为7.1±4.1(0 - 19)mm。88例患者在ESWL后立即进行的计算机断层扫描显示,28.4%的患者胆囊壁有低密度增厚(3 - 10 mm)。这被解释为壁水肿,均为可逆性。1例患者发生包裹性胆囊破裂,2例患者发生胆源性胰腺炎。所有患者均无需急诊手术。12个月后,93例患者(74.9%)无结石残留。如果遵循某些标准并选择合适的患者,可以获得较高的成功率。