Suzuki K, Chiba T, Usami T, Sudoko H, Tajima A, Kawabe K, Aso Y
Department of Urology, Yaizu Municipal Hospital.
Nihon Hinyokika Gakkai Zasshi. 1990 Sep;81(9):1367-71. doi: 10.5980/jpnjurol1989.81.1367.
From March 1989 through December 1989, 123 patients, 9 to 78 years old, were treated by extracorporeal shock wave lithotripsy (ESWL) with the Wolf Piezolith device. Outpatient treatment was performed routinely. Anesthesia was not required in all of the patients. No analgesia or sedation was given routinely. When pyuria had been found before treatment, a course of prophylactic oral antibiotics was given. Treatment consisted of 2000 to 6000 shocks in adults. The need for re-treatment was decided on the basis of the follow up X-rays. Fragmentation into particles 5 mm in size or less occurred in 144 of the 149 renoureteral units (96.6%). Unfragmented stones were treated successfully by the combination therapy of ESWL and fiberoptic transurethral nephroureterolithotripsy (f-TUL). Of 144 renoureteral units, 3-month follow-up data are available for 96. Among the 96 units, the rate of being free of stones was 67 per cent for renal stones and 96 per cent for ureteral stones treated in situ. The over-all rate of being free of stones was 80.2 per cent. There were no significant complications. Ultrasound imaging has proved to be as effective as X-ray imaging. Outpatient ESWL with the Wolf Piezolith device is considered to be safe and efficient for the initial treatment of urinary stones. On the other hand, ESWL monotherapy is not sufficient for the treatment of complete staghorn calculi or long-term impacted ureteral calculi. We think that the combination use of ESWL and f-TUL is the most effective procedure for treatment of complicated stones.
1989年3月至1989年12月，使用Wolf Piezolith设备对123例年龄在9至78岁的患者进行了体外冲击波碎石术（ESWL）治疗。常规进行门诊治疗。并非所有患者都需要麻醉。未常规给予镇痛或镇静药物。治疗前发现脓尿时，给予一个疗程的预防性口服抗生素。成人的治疗包括2000至6000次冲击。根据随访X线片决定是否需要再次治疗。149个肾输尿管单位中的144个（96.6%）结石碎成了5毫米及以下的颗粒。未碎的结石通过ESWL与纤维光学经尿道肾输尿管碎石术（f-TUL）联合治疗成功处理。在144个肾输尿管单位中，96个有3个月的随访数据。在这96个单位中，原位治疗的肾结石无结石率为67%，输尿管结石为96%。总的无结石率为80.2%。无显著并发症。超声成像已被证明与X线成像一样有效。使用Wolf Piezolith设备进行门诊ESWL被认为对尿路结石的初始治疗安全有效。另一方面，ESWL单一疗法不足以治疗完全鹿角形结石或长期嵌顿的输尿管结石。我们认为ESWL与f-TUL联合使用是治疗复杂结石最有效的方法。
