Chen Yi-Zhong, Lin Wun-Rong, Lee Chih-Chiao, Sun Fang-Ju, Chow Yung-Chiong, Tsai Wei-Kung, Chiang Pai-Kai, Lin Ting-Po, Chen Marcelo, Chiu Allen W
Department of Urology, MacKay Memorial Hospital.
School of Medicine, MacKay Medical College.
Clin Interv Aging. 2017 Apr 11;12:667-672. doi: 10.2147/CIA.S134750. eCollection 2017.
This study compared the clinical outcomes of extracorporeal shock wave lithotripsy between elderly (aged $65 years) and non-elderly (aged <65 years) patients.
A retrospective review of medical records was performed on 483 (non-elderly: 245, elderly: 238) patients with upper urinary tract stones who underwent shock wave lithotripsy between 2007 and 2015. The demographic data, stone parameters, stone-free rate, retreatment rate, and complication rate were analyzed in both elderly and non-elderly patient groups.
There was no significant difference between non-elderly and elderly patients in terms of stone-free rate (46.5% vs 41.1%, >0.05) regardless of stone site or stone size and overall retreatment rate (41.6% vs 37.0%, >0.05). Elderly patients had a higher complication rate than non-elderly patients (15.5% vs 23.5%, =0.026). The most common complication was flank pain. Receiver operating characteristic curves predicted that elderly patients (cutoff value: 65 years of age) had a higher risk of complications and that patients with smaller stones (cutoff value: 0.8 cm) had a higher stone-free rate.
This study showed that elderly patients with upper urinary tract stones undergoing shock wave lithotripsy had comparable efficacy for stone-free rates and retreatment rates, but higher complication rates.
本研究比较了老年（年龄≥65岁）和非老年（年龄<65岁）患者体外冲击波碎石术的临床结果。
对2007年至2015年间接受冲击波碎石术的483例上尿路结石患者（非老年：245例，老年：238例）的病历进行回顾性分析。分析了老年和非老年患者组的人口统计学数据、结石参数、结石清除率、再次治疗率和并发症发生率。
无论结石部位、结石大小和总体再次治疗率如何，非老年和老年患者在结石清除率方面无显著差异（46.5%对41.1%，P>0.05）（41.6%对37.0%，P>0.05）。老年患者的并发症发生率高于非老年患者（15.5%对23.5%，P=0.026）。最常见的并发症是胁腹疼痛。受试者工作特征曲线预测，老年患者（临界值：65岁）并发症风险较高，结石较小的患者（临界值：0.8 cm）结石清除率较高。
本研究表明，接受冲击波碎石术的老年上尿路结石患者在结石清除率和再次治疗率方面疗效相当，但并发症发生率较高。
