Ibrahim Rabie M, Elzawy Faysal, Ragheb Ahmed Mohamed, Elmarakbi Akram A, Sayed Osama, Lotfy Amr M, Youssef Ahmed, Badwy Hany F, Mohamed Ahmed Gamal
Department of Urology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt.
Urol Ann. 2024 Jan-Mar;16(1):104-107. doi: 10.4103/ua.ua_42_22. Epub 2024 Jan 25.
The objective of the study y was to evaluate factors which can improve shock wave lithotripsy (SWL) results to keep up with COVID-19 pandemic.
Between June 2020 and June 2021, patients with radio-opaque or faint radio-opaque upper urinary tract stones, stone attenuation value ≤1200 HU, and stones size <2.5 cm were treated by electrohydraulic SWL. Patients with respiratory tract symptoms elevated temperature, contact with COVID-19 patients, or positive COVID-19 swab 2 weeks preoperatively, skin-to-stone distance >11 cm, and body mass index >30 kg/m were excluded from the study. Patients were prospectively enrolled in SWL done at a rate of 40-50 SWs/min under combined ultrasound and fluoroscopy-guided, ramped into high power in the 1 300 shocks. Success rate and complications were recorded.
Five hundred and ninety patients completed the study. The success rate after 1 session was 408/590 patients (69.15%) which was augmented by 2 session to reach 527/590 patients 89.3%. The success rate was 96.2% at 3 months postoperatively. Most complications were mild (Grade 1 or 2).
SWL results improved using slow rate high power from the start of the session under combined fluoroscopy and ultrasound guidance. SWL may be a preferred option during a pandemic.
本研究的目的是评估在新冠疫情期间可提高冲击波碎石术（SWL）效果的因素。
2020年6月至2021年6月期间，对不透X线或轻度不透X线的上尿路结石、结石衰减值≤1200 HU且结石大小<2.5 cm的患者采用液电式SWL进行治疗。排除术前2周有呼吸道症状、体温升高、接触过新冠患者或新冠病毒拭子检测呈阳性、皮肤至结石距离>11 cm以及体重指数>30 kg/m²的患者。患者在超声和荧光透视联合引导下，以40 - 50次冲击波/分钟的频率前瞻性纳入SWL治疗，在1300次冲击中逐渐增加至高能量。记录成功率和并发症情况。
590例患者完成了研究。单次治疗后的成功率为408/590例患者（69.15%），经二次治疗后成功率提高至527/590例患者（89.3%）。术后3个月成功率为96.2%。大多数并发症为轻度（1级或2级）。
在荧光透视和超声联合引导下，从治疗开始就采用低频率高能量的方式可提高SWL的治疗效果。在疫情期间，SWL可能是一种首选的治疗方法。
