Doré B, Grange P, Aubert J
Service d'Urologie, CHU, Poitiers.
Ann Urol (Paris). 1990;24(1):21-6.
137 patients were treated by ESWL with a Sonolith 2000 lithotriptor using ultrasonography localization. 132 patients were eligible for review. Calculi were caliceal in 85 cases, pelvic in 51 cases, in the upper ureter in 1 case; 26 stones were treated by the "push and bang" technique with ureteric stent. Fragmentation rate was 83.9% and stone free rate at 3 months was 68.5%. Failure cases were reviewed: non fragmentation (16.1%) and insufficient fragmentation (15.6%): 14 calculi were analysed by infra red spectrophotometry and correlated with radiodensity on pre ESWL plain X-ray. Hardness and friability criteria were described. Calculi with different radiographic appearances respond differently to shock wave fragmentation. Some stone compositions such as calcium oxalate monohydrate pure or mixed with apatite and calcified uric acid are difficult to break by ESWL. These calculi represented almost 30% of the series. Another treatment should be proposed to improve the results of ESWL.
137例患者使用Sonolith 2000型体外冲击波碎石机，采用超声定位进行体外冲击波碎石术（ESWL）治疗。132例患者符合复查条件。结石位于肾盏85例，肾盂51例，输尿管上段1例；26枚结石采用输尿管支架“推撞”技术治疗。碎石率为83.9%，3个月时结石清除率为68.5%。对失败病例进行了复查：未碎石（16.1%）和碎石不充分（15.6%）：14枚结石通过红外分光光度法分析，并与ESWL术前平片上的放射密度相关。描述了硬度和易碎性标准。具有不同放射学表现的结石对冲击波碎石的反应不同。一些结石成分，如纯一水草酸钙或与磷灰石和钙化尿酸混合的结石，很难通过ESWL破碎。这些结石占该系列的近30%。应提出另一种治疗方法以改善ESWL的治疗效果。
