Miller K, Bachor R, Sauter T, Hautmann R
Division of Urology, University of Ulm, FRG.
Urol Int. 1990;45(2):95-8. doi: 10.1159/000281678.
From December 1986 through March 1988, 52 renal units (RU) with large stone burden have been treated by ESWL monotherapy. In all patients a ureteral stent was placed prior to lithotripsy, to provide drainage of the kidney during the period of stone passage. Data of 43 RU were collected for the present report. Complications ; following treatment were infrequent (2%), whereas auxiliary measures became necessary in 32% of the patients. After a mean follow-up of 9.1 months, 54% of the patients were found stone-free. Stratification according to different stone types and compositions revealed that none of the 7 patients with complete staghorns could be completely cleared and that struvite stones had a significantly better outcome than calcium oxalate stones (75 vs. 25%). Consequently, for a large but not excessive stone burden in a normal or only slightly dilated renal collecting system, ESWL monotherapy under the protection of a ureteral stent may be a comparably safe alternative to percutaneous surgery.
从1986年12月到1988年3月，52个结石负荷较大的肾单位（RU）接受了体外冲击波碎石术（ESWL）单一疗法治疗。所有患者在碎石术前均放置了输尿管支架，以便在结石排出期间为肾脏提供引流。本报告收集了43个肾单位的数据。治疗后的并发症发生率较低（2%），而32%的患者需要辅助措施。平均随访9.1个月后，54%的患者结石清除。根据不同的结石类型和成分进行分层显示，7例完全鹿角形结石患者中无一例能完全清除结石，磷酸镁铵结石的治疗效果明显优于草酸钙结石（75%对25%）。因此，对于正常或仅轻度扩张的肾集合系统中结石负荷较大但不过大的情况，在输尿管支架保护下的ESWL单一疗法可能是经皮手术相对安全的替代方法。
