[弹道式（碎石器）和水电式（瑞瓦碎石机）输尿管内碎石术。60例报告]

[Ballistic (Lithoclast) and hydro-electric (Riwolith) endo-ureteral lithotripsy. Report of 60 cases].

作者信息

Robert M, Bennani A, Chevallier P, Guiter J, Averous M, Grasset D

机构信息

Service d'Urologie, Hôpital Lapeyronie, Montpellier.

出版信息

Prog Urol. 1993 Jun;3(3):438-43.

PMID:8369822

Abstract

25 hydroelectric endoureteric lithotripsies (Group 1, Riwolith) and 35 ballistic endoureteric lithotripsies (Group 2, Lithoclast) were analysed. 60 stones were treated, including 18 pelvic stones (Group 1 : 10, Group 2 : 8), 39 iliolumbar stones (Group 1 : 14, Group 2 : 25), and 3 stones of the ureteropelvic junction (Group 1 : 1, Group 2 : 2). The mean maximal diameter was 9.9 mm (Group 1 : 8.2, Group 2 : 11). Complementary Dormia extraction was performed in 24 cases (Group 1 : 8, Group 2 : 16), 55 double J stents were implanted (Group 1 : 24, Group 2 : 31) and 23 immediate ECL sessions were performed (Group 1 : 8, Group 2 : 15). Overall, 57 good results were recorded, but 3 complete failures of fragmentation and 2 severe ureteric lesions were attributed to hydroelectric lithotripsy. The Lithoclast, much less traumatic, had a greater stone fragmentation potential, but its efficacy on very mobile stones is limited due to its more intense stone propulsion effect.

摘要

对25例水电式输尿管内碎石术（第1组，Riwolith）和35例弹道式输尿管内碎石术（第2组，Lithoclast）进行了分析。共治疗60块结石，其中包括18块肾盂结石（第1组：10块，第2组：8块）、39块髂腰段结石（第1组：14块，第2组：25块）以及3块输尿管肾盂连接处结石（第1组：1块，第2组：2块）。平均最大直径为9.9毫米（第1组：8.2毫米，第2组：11毫米）。24例患者进行了辅助Dormia取石术（第1组：8例，第2组：16例），植入了55根双J支架（第1组：24根，第2组：31根），并进行了23次即时体外冲击波碎石术（ECL）治疗（第1组：8次，第2组：15次）。总体而言，记录到57例良好结果，但有3例碎石完全失败，2例严重输尿管损伤归因于水电式碎石术。Lithoclast创伤性小得多，具有更大的碎石潜力，但其对极活动结石的疗效因较强的结石推进作用而受限。