体外冲击波碎石术治疗肾及输尿管结石的疗效

Outcomes of extra corporeal shock wave lithotripsy in renal and ureteral calculi.

作者信息

Joshi H N, Karmacharya R M, Shrestha R, Shrestha B, de Jong I J, Shrestha R K M

机构信息

Department of Surgery, Dhulikhel Hospital- Kathmandu University Hospital Kathmandu University School of medical Science, Dhulikhel, Kavre, Nepal.

Department of Pharmacology,Dhulikhel Hospital- Kathmandu University Hospital Kathmandu University School of medical Science, Dhulikhel, Kavre, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2014 Jan-Mar;12(45):51-4. doi: 10.3126/kumj.v12i1.13639.

DOI:10.3126/kumj.v12i1.13639

PMID:25219995

Abstract

BACKGROUND

Since the introduction in early 1980s, Extracorporeal Shockwave Lithotripsy (ESWL) became the accepted first line treatment modality for renal and upper ureteric stones. It is simple, safe and effective noninvasive procedure which can be performed without anaesthesia in outpatient basis. The objective of this study was to determine the efficacy of ESWL to achieve complete stone clearance in the patients with different sizes of renal and upper ureteric stones.

OBJECTIVE

The aim of this study was to assess the outcome, efficacy and complications of ESWL in the treatment for renal and ureteric stones in terms of the site and the size of the stone in the patients presented at Dhulikhel Hospital Kathmandu University Hospital.

METHOD

In this prospective study a total of 430 (214 renal and 216 ureteric) cases of urinary stone disease in 257 male and 173 female patients treated by ESWL at Dhulikhel Hospital, Kathmandu University Teaching Hospital during time period of May 2010 to June 2012 were included. Data of patients with renal and ureteric stones were evaluated for stone site, size, and number of sessions. Data were analyzed using spss 13.0.

RESULT

Out of 430 cases, the overall stone free rate in after 1st session was 341 (79.3%) at one month and in three months follow up (3 sessions) it was increased up to 414 (96.3%). In 16 (3.7%) patients treatment was failed. Average size of the stone was 12.24 (SD± 3.65) mm. Stone free rate was 154 (72%) in the case of renal and 187 (86.6%) in the case of ureteric stones in first session. In three months follow up (three sessions) it was 204 (95.4%) and 210 (97.2%) respectively for renal and ureteric stones. In relation to size the stone free rate in <10 mm, 10-15 mm and > 15 mm was 97%, 97% and 90%.

CONCLUSION

ESWL is the first line preferred choice for renal and upper ureteric stones which provides the maximum stone free rate in the case of stone size smaller than 1.5 cm.

摘要

背景

自20世纪80年代初体外冲击波碎石术（ESWL）被引入以来，它已成为肾和输尿管上段结石公认的一线治疗方式。这是一种简单、安全且有效的非侵入性手术，可在门诊无需麻醉的情况下进行。本研究的目的是确定ESWL对不同大小的肾和输尿管上段结石患者实现结石完全清除的疗效。

目的

本研究的目的是根据加德满都大学杜利凯尔医院收治患者的结石部位和大小，评估ESWL治疗肾和输尿管结石的结果、疗效及并发症。

方法

在这项前瞻性研究中，纳入了2010年5月至2012年6月期间在加德满都大学教学医院杜利凯尔医院接受ESWL治疗的257例男性和173例女性患者的总共430例（214例肾结石和216例输尿管结石）尿路结石病病例。对肾结石和输尿管结石患者的数据进行结石部位、大小及治疗次数的评估。数据使用spss 13.0进行分析。

结果

在430例病例中，第一次治疗后1个月时总的结石清除率为341例（79.3%），在3个月随访（3次治疗）时增至414例（96.3%）。16例（3.7%）患者治疗失败。结石平均大小为12.24（标准差±3.65）mm。第一次治疗时肾结石的结石清除率为154例（72%），输尿管结石为187例（86.6%）。在3个月随访（3次治疗）时，肾结石和输尿管结石的结石清除率分别为204例（95.4%）和210例（97.2%）。就结石大小而言，<10 mm、10 - 15 mm和>15 mm的结石清除率分别为97%、97%和90%。