Chongruksut Wilaiwan, Lojanapiwat Bannakij, Tawichasri Chamaiporn, Paichitvichean Somboon, Euathrongchit Jantima, Ayudhya Vorvat Choomsai Na, Patumanond Jayanton
Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Med Assoc Thai. 2011 Sep;94(9):1077-83.
To estimate and compare the incidence rate of kidney stone recurrence and regrowth after ESWL with PCNL at one, two, and three years.
A retrospective cohort study was performed The study recruited patients aged more than 18 years, diagnosed with kidney stones and treated by ESWL or PCNL between January 2006 and August 2010 at the urological unit of a university hospital located in the northern part of Thailand. Data were retrieved from medical records and analyzed using exact probability test or student's t-test. Poisson regression was used to compare the recurrence rate and the regrowth rate between ESWL and PCNL.
During three years of follow-up, the overall stones recurrence and regrowth were 15.5% and 25.1% in ESWL group and 12.6% and 16% in PCNL group, repectively. At one, two and three years after treatment, stones recurrence rate in the ESWL group were 13.1, 7.5 and 7.3 per 1,000 patient-months while in the PCNL group were 11.3, 6.1 and 5.4 per 1,000 patient-months. After ESWL stones regrowth rates were 29.1, 12.3 and 11.9 per 1,000 patient-months, whereas after PCNL were 11.3, 6.9 and 6.9 per 1,000 patient-months, respectively. In comparison to PCNL, the relative recurrence rate after ESWL presented as incidence rate ratio (IRR) were 1.1 (95% CI; 0.4-3.2, p = 0.762), 1.2 (95% CI; 0.6-2.6, p = 0.517) and 1.4 (95% CI; 0.8-2.5, p = 0.271) at 1, 2 and 3 years, respectively. For regrowth, the IRRs were 2.6 (95% CI; 1.1-6.5, p = 0.012), 1.8 (95% CI; 0.9-3.4, p = 0.048), and 1.7 (95%CI; 1.1-2.9, p = 0.017) at 1, 2 and 3 years, respectively.
Patients after ESWL had a higher trend ofrecurrent rates and statistically significant higher regrowth rates, in comparison with those after PCNL.
评估并比较体外冲击波碎石术（ESWL）与经皮肾镜取石术（PCNL）后1年、2年和3年肾结石复发和再生长的发生率。
进行了一项回顾性队列研究。该研究纳入了年龄超过18岁、被诊断为肾结石且于2006年1月至2010年8月在泰国北部一所大学医院泌尿外科接受ESWL或PCNL治疗的患者。数据从病历中获取，并使用确切概率检验或学生t检验进行分析。采用泊松回归比较ESWL和PCNL之间的复发率和再生长率。
在三年的随访期间，ESWL组结石总体复发率和再生长率分别为15.5%和25.1%，PCNL组分别为12.6%和16%。治疗后1年、2年和3年，ESWL组每1000患者月的结石复发率分别为13.1、7.5和7.3，而PCNL组分别为11.3、6.1和5.4。ESWL后每1000患者月的结石再生长率分别为29.1、12.3和11.9，而PCNL后分别为11.3、6.9和6.9。与PCNL相比，ESWL后的相对复发率以发病率比（IRR）表示，在1年、2年和3年时分别为1.1（95%CI；0.4 - 3.2，p = 0.762）、1.2（95%CI；0.6 - 2.6，p = 0.517）和1.4（95%CI；0.8 - 2.5，p = 0.271）。对于再生长，IRR在1年、2年和3年时分别为2.6（95%CI；1.1 - 6.5，p = 0.012）、1.8（95%CI；0.9 - 3.4，p = 0.048）和1.7（95%CI；1.1 - 2.9，p = 0.017）。
与接受PCNL治疗的患者相比，接受ESWL治疗的患者复发率有更高的趋势，且再生长率在统计学上显著更高。
