Vanderpool D, Jones R C, O'Leary J P, Hamilton J K
Department of Surgery, Baylor University Medical Center, Dallas, Texas.
Am J Surg. 1989 Sep;158(3):194-7. doi: 10.1016/0002-9610(89)90251-1.
At Baylor University Medical Center in Dallas, we began performing lithotripsy with the Medstone STS lithotripter for gallstones in January 1988 and in the first year treated 81 patients. Fifty-five of these patients were available for 4-month follow-up. We randomized half of the patients to receive ursodeoxycholic acid for 7 days prior to lithotripsy and gave all of the patients ursodeoxycholic acid after lithotripsy. Only 10.4 percent of the patients who contacted us ultimately proved to be candidates for lithotripsy. Gallstone fragmentation occurred in 95 percent of all patients and in 97 percent of those patients with solitary stones under 20 mm in size. The rate of clearance for solitary stones less than 20 mm in size was 50 percent. Unfavorable effects ascribable to lithotripsy were infrequent. All of the patients had pain before treatment, and one-third complained of biliary colic after treatment. Minor skin bruising which resolved in 1 to 5 days was found in 20 percent of the patients. This study lends credence to the findings of previous studies and demonstrates that lithotripsy combined with bile acid therapy is a useful therapy for cholelithiasis.
1988年1月，在达拉斯的贝勒大学医学中心，我们开始使用Medstone STS碎石机对胆结石进行碎石治疗，第一年共治疗了81例患者。其中55例患者接受了为期4个月的随访。我们将一半患者随机分组，在碎石术前7天给予熊去氧胆酸，所有患者在碎石术后均给予熊去氧胆酸。最终，只有10.4%与我们联系的患者被证明适合进行碎石治疗。所有患者中有95%出现了胆结石破碎，在那些结石尺寸小于20毫米的单发结石患者中，这一比例为97%。尺寸小于20毫米的单发结石清除率为50%。与碎石治疗相关的不良反应并不常见。所有患者在治疗前均有疼痛，三分之一的患者在治疗后出现胆绞痛。20%的患者出现轻微皮肤瘀伤，1至5天内消退。这项研究证实了先前研究的结果，并表明碎石术联合胆汁酸疗法是一种治疗胆石症的有效方法。
