Andreassen K H, Dahl C, Andersen J T, Rasmussen M S, Jacobsen J D, Mogensen P
Copenhagen Municipal Stone Center, Department of Urology Bispebjerg Hospital, University of Copenhagen, Denmark.
Scand J Urol Nephrol. 1997 Jun;31(3):245-8. doi: 10.3109/00365599709070341.
Eighty-four patients with solitary calyceal stones were treated with Extracorporeal Shock Wave Lithotripsy (ESWL) as first line monotherapy. The indications for treatment were pain in 51 patients (61%), infection in 11 patients (13%), pain and infection in 18 patients (21%) and others in 4 patients (5%). Stone size (largest diameter) was median 9 mm (range 2-25 mm). Follow-up consisted of clinical control, isotope renography and a plain film after 1 month; hereafter plain films after 3 and 6 months. Auxiliary procedures due to steinstrasse were performed in 3 out of 4 patients (1 nephrostomy, 1 nephrostomy + ESWL of ureteral fragments, and 1 ureteroscopic manipulation). Retreatment of the calyceal stone was performed in 3 patients within 6 months (2 re-ESWL, 1 lower pole resection). Stone-free (without retreatment or auxiliary procedures) were 26/84 (31%) after 1 month, 34/84 (40%) after 3 months and 38/84 (45%) after 6 months. Free of pain were 43/69 (62%) after 1 month, 50/69 (72%) after 3 months and 59/69 (86%) after 6 months. Free of infection were 18/29 (62%) after 1 month, 19/29 (66%) after 3 months and 21/29 (72%) after 6 months. Complications included steinstrasse in 4 patients, sepsis in 3 patients, displacement of JJ-stent in 2 patients and atrio-ventricular dissociation in 1 patient. To conclude: ESWL as first line therapy for solitary calyceal calculi offers good results with regard to pain and clearance of infection, but leaves 55% with residual stone material.
84例孤立肾盏结石患者接受了体外冲击波碎石术（ESWL）作为一线单一疗法。治疗指征为：51例患者（61%）有疼痛，11例患者（13%）有感染，18例患者（21%）有疼痛和感染，4例患者（5%）有其他情况。结石大小（最大直径）中位数为9毫米（范围2 - 25毫米）。随访包括1个月后进行临床检查、同位素肾图检查和平片检查；此后在3个月和6个月时进行平片检查。4例患者中有3例因石街进行了辅助操作（1例肾造瘘术，1例肾造瘘术 + 输尿管碎片ESWL，1例输尿管镜操作）。3例患者在6个月内对肾盏结石进行了再次治疗（2例再次ESWL，1例下极切除术）。1个月后结石清除（无需再次治疗或辅助操作）率为26/84（31%），3个月后为34/84（40%），6个月后为38/84（45%）。1个月后无痛率为43/69（62%），3个月后为50/69（72%），6个月后为59/69（86%）。1个月后无感染率为18/29（62%），3个月后为19/29（66%），6个月后为21/29（72%）。并发症包括4例患者出现石街，3例患者出现脓毒症，2例患者的双J管移位，1例患者出现房室传导阻滞。结论：ESWL作为孤立肾盏结石的一线治疗方法在疼痛缓解和感染清除方面效果良好，但仍有55%的患者残留结石物质。
