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以坐骨大孔和坐骨小孔作为仰卧位体外冲击波碎石术治疗输尿管下段结石的路径。

Sciaticum majus foramen and sciaticum minus foramen as the path of SWL in the supine position to treat distal ureteral stone.

作者信息

Lu Jianlin, Sun Xizhao, He Lei

机构信息

Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, Jiangsu, China.

出版信息

Urol Res. 2010 Dec;38(6):417-20. doi: 10.1007/s00240-010-0285-2. Epub 2010 Jul 13.

Abstract

The purpose of the study is to evaluate the efficacy and safety of shock wave lithotripsy (SWL) using sciaticum majus foramen and sciaticum minus foramen as the path to treat distal ureteral stone in supine position. Between December 2006 and November 2008, 243 cases of distal urinary calculi were treated in our department using SWL or ureteroscopy. 189 cases for SWL were treated in supine position. The shockwave target on the stone in distal ureter via sciaticum majus foramen and sciaticum minus foramen, avoiding the sacroiliac joint. 54 cases were underwent ureteroscopy combined with holmium:YAG laser lithotripsy. The stone-free rate and the efficacy quotient (EQ) for SWL and ureteroscopy was 81.5%, 0.68; 94.4%, 0.78; respectively (p = 0.02). The retreatment rate for SWL and ureteroscopy was 14.6%, 0, respectively. The number of the shocks ranged from 600 to 3,000 (mean 2,566.3 ± 378.8). The energy per pulse of SWL ranged from 8 to 12 kV (mean 10.7). SWL in the supine position using sciaticum majus foramen and sciaticum minus foramen as the path is a choice of the treatment of distal ureteral stones with an excellent success rate and low side effect.

摘要

本研究的目的是评估以坐骨大孔和坐骨小孔为路径在仰卧位使用冲击波碎石术(SWL)治疗输尿管下段结石的疗效和安全性。2006年12月至2008年11月期间,我科使用SWL或输尿管镜治疗了243例输尿管下段结石患者。其中189例采用仰卧位SWL治疗,通过坐骨大孔和坐骨小孔将冲击波对准输尿管下段结石,避开骶髂关节。54例行输尿管镜联合钬激光碎石术。SWL和输尿管镜的结石清除率及疗效商数(EQ)分别为81.5%,0.68;94.4%,0.78(p = 0.02)。SWL和输尿管镜的再次治疗率分别为14.6%,0。冲击波次数为600至3000次(平均2566.3±378.8)。SWL的每次脉冲能量为8至12 kV(平均10.7)。以坐骨大孔和坐骨小孔为路径在仰卧位进行SWL是治疗输尿管下段结石的一种选择,成功率高且副作用低。

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