体外冲击波碎石对不同部位肾结石非靶区的影响及观察

Extracorporeal shock wave lithotripsy effect on non-target areas in various renal stones

目的:观察体外冲击波碎石对不同部位肾结石非靶区的影响。方法:将6 149例肾结石患者分为肾上盏结石组、肾中盏结石组和肾下盏结石组,对比分析不同部位肾结石非靶区的肾脏CT灌注图像参数、排石成功率及并发症率差异。结果:体外冲击波碎石术均对结石患者术后肾结石非靶区均有所损伤,且体外冲击波能量大于11 k V时肾损伤程度迅速提升;E<9能量波碎石的排石成功率明显高于E≥9能量波碎石,E≥11能量波碎石的并发症率低于E<11能量波碎石。结论:当冲击波能量在9~11 k V区间时,不仅对患者非靶区损伤影响较低,而且排石成功率和并发症发生率也较低,冲击波能量选择在9~11 k V区间是肾结石患者治疗的最优能量方案。

Objective To observe the effect of extracorporeal shock wave lithotripsy on non target areas for various renal calculi. Methods Six thousand, one hundred and forty-nine cases of renal calculi patients were divided into 3 groups based on the calculi positions, including the superior renal calices group, the middle renal caliees group and the inferior renal calices group. We compared the renal CT perfusion parameters in the non target areas of renal stones, successful rates of removing stones and complications. Results Extracorporeal shock wave lithotripsy had renal injures on both target areas and non target areas. When the extracorporeal energy is greater than 11 kV, the kidney damages became severe rapidly. When the E 〈 9, lithotripsy successful rate was signifi- cantly higher than that of E ~〉 9 ; when E ~〉 11 , the energy wave lithotripsy complication rates were less than that of E 〈 11 energy wave lithotripsy. Conclusions When the shock wave energy is in the range of 9 - 11 kV, there is not only low injuries on non target areas, but also low successful rates of removing stones and complication rates. So the shock wave energy in a range of 9 - 11 kV is the best choice of energy regimen in treatment of patients with renal stones.