Dore B, Grange P H, Aubert J
Acta Urol Belg. 1989;57(3):743-54.
137 patients were treated by ESWL with Sonolith 2000 lithotriptor using ultrasonography localisation. 132 patients were eligible for review. Calculi were caliceal in 85, pelvic in 51, in upper ureter in 1; 26 stones were treated by the push and bang technique with an ureteric stent. Fragmentation rate was 83.9% and stone free rate at 3 months was 68.5%. Failure were reviewed: non fragmentation (16.1%) and insufficient fragmentation (15.1%). 14 calculi were analysed by infra red spectrophotometry and correlated with radiodensity on pre ESWL plain X-ray. Hardness and friability criteria are described. Calculi of different radiographic aspects respond differently to shock wave fragmentation. Some stone composition as calcium oxalate monohydrate pure or mixed with apatite and calcified uric acid are difficult to break by ESWL. Those calculi represented almost 30% of the series. This criteria of hardness has to be taken into account for the selection of patients in order to improve the results of ESWL.
137例患者使用Sonolith 2000碎石机,采用超声定位进行体外冲击波碎石术(ESWL)治疗。132例患者符合复查条件。结石位于肾盏的有85例,位于肾盂的有51例,位于输尿管上段的有1例;26枚结石采用推送冲击技术并置入输尿管支架进行治疗。碎石率为83.9%,3个月时结石清除率为68.5%。对治疗失败情况进行了分析:未碎石(16.1%)和碎石不充分(15.1%)。对14枚结石进行了红外分光光度法分析,并与ESWL术前平片上的放射密度进行了关联。描述了硬度和易碎性标准。不同影像学表现的结石对冲击波碎石的反应不同。一些结石成分,如纯一水草酸钙或与磷灰石和钙化尿酸混合的结石,很难被ESWL击碎。这些结石在该系列中占近30%。为了提高ESWL的治疗效果,在选择患者时必须考虑这种硬度标准。