Lazare J N, Saltzman B, Sotolongo J
Department of Urology, Mount Sinai Medical Center, New York, New York.
J Urol. 1988 Aug;140(2):266-9. doi: 10.1016/s0022-5347(17)41579-5.
A total of 32 male patients with spinal cord injury underwent extracorporeal shock wave lithotripsy. The mean stone burden was 2.9 cm. (range 0.2 to 8.0 cm.) per renal unit. Of 41 renal units 27 (66 per cent) required ancillary endourological procedures preoperatively and 32 (78 per cent) required a single treatment with extracorporeal shock wave lithotripsy. Urine cultures were positive in 30 of 32 patients (94 per cent) before treatment. All patients with positive preextracorporeal shock wave lithotripsy urine cultures also had positive cultures after treatment. Followup (3-month) was available for 26 of 41 renal units (63 per cent) and showed 19 (73 per cent) to be free of stones or without any radiographic evidence of calcification overlying the collecting system. Seven staghorn calculi were treated with extracorporeal shock wave lithotripsy without prior debulking procedures. Two partial staghorn calculi were treated and rendered free of stones. None of the 5 kidneys with full staghorn calculi was rendered free of stones. We conclude that extracorporeal shock wave lithotripsy is effective for the treatment of unbranched and partial staghorn calculi in the spinal cord injury patient. However, extracorporeal shock wave lithotripsy alone is less effective for the treatment of full staghorn calculi.
共有32例男性脊髓损伤患者接受了体外冲击波碎石术。每个肾单位的平均结石负荷为2.9厘米（范围为0.2至8.0厘米）。在41个肾单位中，27个（66%）术前需要辅助腔内泌尿外科手术，32个（78%）需要单次体外冲击波碎石治疗。治疗前32例患者中有30例（94%）尿培养呈阳性。所有体外冲击波碎石术前尿培养阳性的患者治疗后尿培养也呈阳性。41个肾单位中有26个（63%）进行了随访（3个月），结果显示19个（73%）无结石或在集合系统上方无任何钙化的影像学证据。7例鹿角形结石未经预先减容手术直接接受体外冲击波碎石治疗。2例部分鹿角形结石接受治疗后结石消失。5例全鹿角形结石患者无一例结石消失。我们得出结论，体外冲击波碎石术对脊髓损伤患者的无分支和部分鹿角形结石治疗有效。然而，单独使用体外冲击波碎石术治疗全鹿角形结石效果较差。
