Urology Clinic, General Hospital Melission Amalia Fleming, Athens, Greece.
Curr Opin Urol. 2010 Mar;20(2):154-8. doi: 10.1097/MOU.0b013e328333b68b.
Shockwave lithotripsy (SWL) is considered as an initial option for a significant proportion of urinary tract stones. Despite efforts for standardized terminology and methodology, published studies on lithotripsy outcome are very different. This review will focus on a brief description of evidence-based medicine and recent literature results on SWL outcome.
The introduction of hierarchy in scientific evidence is becoming more widespread. Various grading systems have attempted to rank recommendations according to type and amount of evidence. Different levels of evidence have been created for therapy, diagnosis and prognosis. Various authors have developed scoring systems and identified radiographic parameters to predict SWL outcome. The long-term safety of lithotripsy on renal function has been demonstrated. Randomized controlled trials and meta-analysis have shown that medical expulsive therapy and a slower shockwave rate will improve SWL outcome.
Evidence-based medicine is rapidly becoming an indispensable part of everyday medical practice. Common terminology is necessary for proper evaluation of SWL. Different types of studies are required to investigate efficacy, compare SWL to other options, complications and so on. Randomized clinical trials are of the highest value; matched-pair analyses and well designed controlled studies can offer significant help.
体外冲击波碎石术（SWL）被认为是相当一部分尿路结石的初始选择。尽管为标准化术语和方法做出了努力，但发表的碎石术结果研究却大不相同。这篇综述将重点介绍循证医学的简要描述以及 SWL 结果的最新文献结果。
科学证据分层的引入变得越来越广泛。各种分级系统试图根据证据的类型和数量对建议进行排名。针对治疗、诊断和预后制定了不同级别的证据。不同的作者已经开发了评分系统并确定了预测 SWL 结果的影像学参数。碎石术对肾功能的长期安全性已得到证实。随机对照试验和荟萃分析表明，药物排石治疗和较慢的冲击波率将改善 SWL 结果。
循证医学正在迅速成为日常医疗实践中不可或缺的一部分。适当评估 SWL 需要使用通用术语。需要进行不同类型的研究来调查疗效、比较 SWL 与其他选择、并发症等。随机临床试验具有最高价值；配对分析和精心设计的对照研究可以提供重要帮助。
