Numa H, Yoshida K, Kageyama Y, Hoshino Y
Department of Urology, Kasukabe Shuwa Hospital.
Hinyokika Kiyo. 1994 Apr;40(4):291-4.
We discuss the effectiveness of in situ extracorporeal shock wave lithotripsy (ESWL) for the ureteral stones causing acute renal failure in 5 patients (4 men and 1 woman, mean age 56.2 years). Three of them had a sole functioning kidney, one had a solitary kidney and the other had bilateral ureteral stones. The obstructing stones were located in the upper ureter in one, lower ureter in 2, upper and lower ureter in one and bilateral upper ureter in one with the average length of the stones being 9.2 mm. We used the EDAP LT-01 device for these stones. The obstructing stones were successfully disintegrated by ESWL alone in three cases, but could not be disintegrated in the other 2 cases in which the obstruction had occurred gradually or there were multiple stones. In the latter 2 cases, we performed ESWL again with percutaneous nephrostomy or hemodialysis. We thus believe that ESWL is a safe and effective procedure and is the first choice of emergency treatment for some ureteral stones causing acute renal failure. However, the subject is limited to acute cases, and the stone must be easily detected, single with its size being less than 12 mm and composed of calcium.
我们讨论了原位体外冲击波碎石术（ESWL）对5例（4例男性，1例女性，平均年龄56.2岁）因输尿管结石导致急性肾衰竭患者的有效性。其中3例患者仅有一个功能肾，1例患者为孤立肾，另1例患者双侧输尿管结石。梗阻性结石位于上段输尿管1例，下段输尿管2例，上、下段输尿管1例，双侧上段输尿管1例，结石平均长度为9.2mm。我们使用EDAP LT - 01设备治疗这些结石。3例患者仅通过ESWL成功击碎梗阻性结石，但另外2例因梗阻逐渐发生或存在多发结石而未能击碎。在这2例患者中，我们再次进行了ESWL，并联合经皮肾造瘘术或血液透析。因此，我们认为ESWL是一种安全有效的治疗方法，是一些导致急性肾衰竭的输尿管结石的首选急诊治疗方法。然而，该方法仅限于急性病例，且结石必须易于检测，为单发，大小小于12mm且由钙组成。
