Lahme S, Wilbert D M, Bichler K H
Urologische Klinik, Eberhard-Karls-Universität, Tübingen.
Urologe A. 1997 May;36(3):226-30. doi: 10.1007/s001200050094.
Almost 75% of all urinary calculi can be treated by extracorporeal shock wave lithotripsy (ESWL). In contrast to endoscopic and open-surgical procedures the patients are not immediately free of stones. The residual fragments after ESWL are called clinically insignificant residual fragments (CIRF), if the fragments are less than 5 mm in size and if there is the possibility of a spontaneous passage. But CIRF can cause ureteral obstruction. In addition, CIRF play an important role for the risk of stone growth and stone recurrence. The metaanalysis shows that it is not advisable to classify the CIRF only by their size. The morphological conditions of the urinary tract also have to be evaluated. Therefore, stone patients with CIRF after ESWL require a close follow-up and timely adjuvant therapy. All aspects mentioned lead to the conclusion to use the term "CIRF" with caution.
几乎所有尿路结石的75%都可以通过体外冲击波碎石术（ESWL）进行治疗。与内镜和开放手术不同，患者并不会立即结石清除。如果ESWL后的残余碎片尺寸小于5毫米且有可能自然排出，则这些残余碎片被称为临床意义不显著的残余碎片（CIRF）。但CIRF可导致输尿管梗阻。此外，CIRF在结石生长和结石复发风险方面起着重要作用。荟萃分析表明，仅根据CIRF的大小进行分类是不可取的。还必须评估尿路的形态状况。因此，ESWL后有CIRF的结石患者需要密切随访并及时进行辅助治疗。上述所有方面都得出结论，应谨慎使用“CIRF”一词。
