Department of Urology, Drum Tower Hospital, Nanjing University, Zhongshan Road 321, 210008, Nanjing, China.
World J Urol. 2011 Dec;29(6):713-7. doi: 10.1007/s00345-010-0592-9. Epub 2010 Dec 14.
To compare the efficacy and safety of Shockwave lithotripsy (SWL) for upper urinary tract stones of various locations in children.
Between 1997 and 2008, a total of 311 children (average age: 7.9 ± 4.4 years, ranged from 6 months to 16 years) with upper urinary tract stones were treated by SWL using Dornier Compact S lithotripter at our department. Of those patients, 196 had renal stones (pelvic, 53; upper and mid calices, 75; lower calices, 68) with an average size of 9.42 ± 7.1 mm, and 115 had ureteral stones (proximal, 53; mid, 16; distal, 46) with an average size of 7.38 ± 5.87 mm.
Overall stone-free rates of renal stones and ureteral stones at 3 months were 95.8% and 94.8% with 83.5% and 79.5% of efficacy quotient (EQ), respectively. In renal stone groups, the EQ for renal pelvic stones was 89.2%, for middle and upper calyx stones was 92.5%, which was higher than 71.9% for lower calices stones. In ureteral stone groups, the 82.3% of EQ for proximal ureteral stones and 83.0% for distal ureteral stones were higher than 63.6% for middle ureteral stones. Patients with larger stones had significant higher re-treatment rate (P < 0.05) and lower EQ than small stone groups. No serious side effect happened in the study.
SWL for both renal stones and ureteral stones in pediatric group have comparable efficacy and safety, except that stones in lower calices and middle ureters have lower EQ than those in other locations.
比较体外冲击波碎石术（SWL）治疗儿童不同部位上尿路结石的疗效和安全性。
1997 年至 2008 年，我院采用 Dornier Compact S 碎石机对 311 例上尿路结石患儿（平均年龄：7.9±4.4 岁，年龄范围为 6 个月至 16 岁）进行 SWL 治疗。其中 196 例为肾结石（肾盂结石 53 例，上、中盏结石 75 例，下盏结石 68 例），结石平均大小为 9.42±7.1mm；115 例为输尿管结石（上段结石 53 例，中段结石 16 例，下段结石 46 例），结石平均大小为 7.38±5.87mm。
3 个月时肾结石和输尿管结石的无石率分别为 95.8%和 94.8%，有效率分别为 83.5%和 79.5%。肾结石组肾盂结石的有效率为 89.2%，中上盏结石为 92.5%，下盏结石为 71.9%。输尿管结石组中，上段输尿管结石的有效率为 82.3%，下段输尿管结石的有效率为 83.0%，均高于中段输尿管结石的 63.6%。结石较大的患者再治疗率明显高于结石较小的患者（P<0.05），且有效率较低。研究中未发生严重不良反应。
SWL 治疗儿童肾结石和输尿管结石的疗效和安全性相当，但肾盂和中输尿管结石的有效率低于其他部位的结石。
