低能量ESWL治疗上尿路结石的临床研究

Clinical Research in Low-energy Extracorporeal Shock-wave Lithotripsy for Treatment of Upper Urinary Tract Calculi

目的与高能量ESWL相比,低能量ESWL治疗上尿路结石是否有相似疗效,且并发症较少。方法选用HB-ESWL-VD碎石机对随机分成低能量组（3~5.5 kV）和高能量组（电压3~7.0 kV）的200例上尿路结石患者进行碎石,观察结石排出过程和并发症。结果低能量组和高能量组患者在术后血尿天数（P=0.01）、肾绞痛发生率（P=0.02）的差异有显著统计学意义（P〈0.05）;在排石时间（P=0.57）、排石率（P=0.66）及二次碎石数（P=0.24）的差异无显著统计学意义（P〉0.05）。结论低能量体外冲击波在有效治疗上尿路结石同时,能减轻患者近期肾损伤的发生。它应该作为上尿路结石的首选治疗。

Objective This study was designed to evaluate the efficiency and complications of low-energy ESWL for upper urinary tract calculi comparing to high-energy ESWL. Methods A prospective study involving 200 patients with upper urinary tract calculi treated by HB-ESWL-VD.According to the level of energy using in ESWL, the patients were randomly dirided into Low-energy group（3-5.5 kV） and high-energy group（3-7.0 kV）. Success rate and renal injury degree were analyzed. Results Success rates（P=0.66）, time of stone excretion（P=0.57）and number of twice lithotipasy of 2 groups showed no significant difference （P〉0.05）, but duration of Postoperative hematuria（P=0.01）and happening of Renal colic（P=0.02）were significant difference（P〈0.05）. Conclusion Comparing to high-energy ESWL, low-energy ESWL is a similar effectiverteatment and more safe tretment for upper urinary tract calculi. So it should be considered the first choice to treat upper urinary tract calculi.