Oka T, Hara T, Miyake O, Kobayashi Y, Yasunaga Y, Matsumiya K, Takaha M
Department of Urology, Osaka National Hospital.
Hinyokika Kiyo. 1990 Oct;36(10):1203-11.
With Sonolith 3000, a new extracorporeal shock wave lithotriptor, we performed extracorporeal shock wave lithotripsy (ESWL) on 34 patients with upper urinary stones, including 5 patients with target stones of this clinical application in both sides. The 39 target stones in the 34 patients were located in the renal calyx (13 cases), renal pelvis (14 cases), renal calyx and pelvis (1 case), renal pelvis and ureter (1 case), and upper ureter (10 cases). The ultrasound-aiming system gave a satisfactory imaging of the target stones in 94.9% of cases (37/39 cases). During the ESWL treatment, 32 patients (94.2%) did not need anesthesia, but 2 patients (5.9%) needed epidural anesthesia because of intolerable pain and/or terror of pain. The average number of treatments per case was 2.08, and the average dose of shock waves per treatment was 3,691.1. The stone-free rate on the 14th, 42nd and 90th days after the last ESWL treatment were 28.2% (11/39), 51.3% (20/39) and 64.1% (25/39), respectively. Out of 39 cases, 31 cases (79.5%) were either stone-free or had only sand-like residual stones on the 90th day. Most cases had minimal side effects, such as transient macroscopic hematuria (100.0%), skin eruption (50.0%) and back pain (41.2%), but one case needed a 1,200 ml transfusion because of perirenal hematoma immediately after 1st session of ESWL treatment with 2,300 shock waves (13 kv). The serum total bilirubin level on 1st day after the last session of ESWL treatment was significantly increased when compared with the preoperative level, but the level was not significantly increased after the 1st session.(ABSTRACT TRUNCATED AT 250 WORDS)
使用新型体外冲击波碎石机Sonolith 3000,我们对34例上尿路结石患者进行了体外冲击波碎石术(ESWL),其中5例患者双侧均有该临床应用的目标结石。34例患者的39枚目标结石位于肾盏(13例)、肾盂(14例)、肾盏和肾盂(1例)、肾盂和输尿管(1例)以及上段输尿管(10例)。超声定位系统在94.9%的病例(37/39例)中对目标结石成像满意。在ESWL治疗期间,32例患者(94.2%)无需麻醉,但2例患者(5.9%)因难以忍受的疼痛和/或对疼痛的恐惧需要硬膜外麻醉。每例患者的平均治疗次数为2.08次,每次治疗的平均冲击波剂量为3691.1次。最后一次ESWL治疗后第14天、42天和90天的结石清除率分别为28.2%(11/39)、51.3%(20/39)和64.1%(25/39)。在39例病例中,31例(79.5%)在第90天时结石完全清除或仅残留沙粒样结石。大多数病例有轻微的副作用,如短暂肉眼血尿(100.0%)、皮疹(50.0%)和背痛(41.2%),但有1例患者在第一次接受2300次冲击波(13千伏)的ESWL治疗后立即因肾周血肿需要输注1200毫升血液。最后一次ESWL治疗后第1天的血清总胆红素水平与术前水平相比显著升高,但第一次治疗后该水平未显著升高。(摘要截取自250字)