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[体外冲击波碎石术的预后参数]

[Prognostic parameters in extracorporeal lithotripsy].

作者信息

Larcher P, De Cobelli O, Carmignani L, Franchini V, Meroni T, Panizzuti M, Strada G, Scardino E, Baccalin A, Rocco F

出版信息

Arch Ital Urol Nefrol Androl. 1989 Dec;61(4):361-5.

PMID:2532399
Abstract

Extracorporeal lithotripsy consists of applying shock waves (electrohydraulic and piezoelectric) from outside the human body, which pass through the body tissues without damaging them breaking down the urinary calculi into particles which can then be automatically expulsed through the excretory tract. The object of this study is to analysis some of the important parameters which affect the success of the extracorporeal lithotripsy. These factors are as follows: 1) type of shock wave: electrohydraulic or piezoelectric, their action mechanism, methods of fragmenting the urolites; 2) the chemical composition of the calculi and its consequential resistance to the fragmented shock waves; 3) Patency, tone and peristalsis of the intra and extrarenal excretory tract for expulsing the urolite particles; 4) general conditions of the urinary apparatus. From the interaction of these 4 variables arise different clinical situations which must be evaluated before operating in order to develop the proper therapeutic subscription for a renal-urethral lithiasis. The current therapeutic procedures for renal-urethral lithiasis are as follows: electrohydraulic and piezoelectric extracorporeal lithotripsy; electrohydraulic waves or ultrasound percutaneous litholapaxy; operative urethroscope; traditional surgery; chemolysis.

摘要

体外冲击波碎石术是通过从人体外部施加冲击波(电液压冲击波和压电冲击波),这些冲击波穿过人体组织而不造成损伤,将尿路结石分解成颗粒,然后这些颗粒可通过排泄系统自动排出体外。本研究的目的是分析一些影响体外冲击波碎石术成功率的重要参数。这些因素如下:1)冲击波类型:电液压冲击波或压电冲击波,它们的作用机制,粉碎尿石的方法;2)结石的化学成分及其对破碎冲击波的相应抗性;3)肾内和肾外排泄系统排出尿石颗粒的通畅性、张力和蠕动;4)泌尿系统的一般状况。这四个变量相互作用产生了不同的临床情况,在进行手术前必须对这些情况进行评估,以便为肾尿道结石制定适当的治疗方案。目前治疗肾尿道结石的方法如下:电液压和压电体外冲击波碎石术;电液压波或超声经皮碎石术;手术尿道镜检查;传统手术;化学溶解。

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