Chan S L, Stothers L, Rowley A, Perler Z, Taylor W, Sullivan L D
Department of Surgery, University of British Columbia, Vancouver, Canada.
J Urol. 1995 Jun;153(6):1794-7.
A prospective randomized study of 198 patients was conducted to compare the efficacy of the modified Dornier HM3 lithotriptor to the MFL 5000 lithotriptor. Entrance criteria included solitary stones at any location within the upper collecting system that had not previously been treated with lithotripsy. Following lithotripsy the patients were evaluated by a blinded radiologist with a plain abdominal film, tomograms and renal ultrasound at 1, 4 and 12 weeks. Patients were classified at 12 weeks after lithotripsy as failing treatment if any stone fragments were imaged. Of the patients 170 were available for complete 3-month followup. No statistical or clinical difference in stone-free rates was apparent for calculi in the ureter or renal pelvis in either group. Of patients with lower caliceal stones 80% had no residual fragments visualized at 12 weeks when treated with the modified HM3 device versus 56% with the MFL 5000 lithotriptor (p = 0.05). Treatment time on the MFL 5000 unit was significantly prolonged compared with the modified HM3 device (0.7 hours versus 0.4 hours, respectively) resulting in fewer patients being treated in a given day (p < 0.001). No statistical difference in complication rates could be found between the 2 machines. Steinstrasse were noted in 10% of the patients treated with the modified HM3 device and 6% of the MFL 5000 group. Subcapsular hematomas were noted in 4% of the MFL 5000 treatment arm compared to 1% in the modified HM3 group. Overall, the MFL 5000 lithotriptor was believed to offer no significant clinical advantage over the modified HM3 device in terms of lithotripsy efficacy, although the multifunctional table did offer more versatility for stone treatment. For a busy lithotripsy center, the modified HM3 lithotriptor is still the most efficacious.
对198例患者进行了一项前瞻性随机研究，以比较改良的多尼尔HM3碎石机与MFL 5000碎石机的疗效。入选标准包括上尿路收集系统内任何位置的孤立结石，这些结石此前未接受过碎石治疗。碎石治疗后，由一名不知情的放射科医生在1周、4周和12周时通过腹部平片、断层扫描和肾脏超声对患者进行评估。如果在12周时成像发现任何结石碎片，则将患者在碎石治疗后12周归类为治疗失败。170例患者可进行完整的3个月随访。两组中输尿管或肾盂结石的无石率在统计学或临床上均无明显差异。对于下盏结石患者，使用改良的HM3设备治疗时，80%在12周时未发现残留碎片，而使用MFL 5000碎石机时这一比例为56%（p = 0.05）。与改良的HM3设备相比，MFL 5000设备的治疗时间显著延长（分别为0.7小时和0.4小时），导致每天接受治疗的患者减少（p < 0.001）。两台机器的并发症发生率在统计学上没有差异。使用改良的HM3设备治疗的患者中有10%出现石街，MFL 5000组为6%。MFL 5000治疗组有4%出现包膜下血肿，而改良HM3组为1%。总体而言，就碎石疗效而言，MFL 5000碎石机被认为与改良的HM3设备相比没有显著的临床优势，尽管多功能治疗台在结石治疗方面确实提供了更多的通用性。对于繁忙的碎石中心来说，改良的HM3碎石机仍然是最有效的。
