[鹿角形结石的治疗]

[The treatment of staghorn calculi].

作者信息

Hatano Y, Segawa A

机构信息

Department of Urology, Aichi Medical University.

出版信息

Hinyokika Kiyo. 1993 Nov;39(11):1087-91.

PMID:8266883

Abstract

Between May 1989 and November 1991, 19 staghorn calculi were treated by extracorporeal shock-wave lithotripsy (ESWL) with a Dornier MFL 5000 or Northgate SD-3. The 19 calculi were evaluated. Treatment was with monotherapy by ESWL in 9, combination percutaneous nephrolithotomy (PNL)-ESWL in 9, and nephrostomy in 1. Of the patients, 14 had a cross stent catheter pre-ESWL treatment to improve fragment evacuation. Radiologic follow up in 19 kidneys revealed that 57.9% were stone free. We arbitrarily separated our cases into 3 groups: struvite renal calculi, calcium carbonate calculi and others. Result of stone-free rate was 100% for stones consisting of struvite, and 14. 3% for stones consisting of calcium carbonate. In our opinion, the best indication of monotherapy by ESWL is for staghorn calculi, which consists of struvite, without marked dilation of pelvis and calyces.

摘要

1989年5月至1991年11月期间，采用多尼尔MFL 5000型或诺斯盖特SD - 3型体外冲击波碎石机（ESWL）治疗了19例鹿角形结石。对这19例结石进行了评估。其中9例采用ESWL单一疗法治疗，9例采用经皮肾镜取石术（PNL）与ESWL联合治疗，1例采用肾造瘘术治疗。在这些患者中，有14例在ESWL治疗前放置了交叉支架导管以促进结石碎片排出。对19个肾脏进行的影像学随访显示，结石清除率为57.9%。我们将病例任意分为3组：鸟粪石肾结石、碳酸钙结石和其他类型。由鸟粪石构成的结石结石清除率为100%，由碳酸钙构成的结石结石清除率为14.3%。我们认为，ESWL单一疗法的最佳适应证是由鸟粪石构成、肾盂和肾盏无明显扩张的鹿角形结石。