低能量体外冲击波碎石对肾鹿角形结石的疗效观察(英)

Therapeutic effect of low energetic extracorporeal shock wave lithotripsyon deerhorn like nephrolith

目的:研究低能量体外冲击波碎石(extracorprealshockwavelihotripsy,ESWL)治疗边缘性鹿角形结石、部分鹿角形结石、完全鹿角形结石的疗效及副作用。方法:应用MZ-V型低能量体外冲击波碎石机治疗边缘性鹿角形结石77例,部分缘性鹿角形结石49例,完全缘性鹿角形结石6例,ESWL治疗后1,3,6月进行B超、KUB检查和随访。结果:边缘性鹿角形结石完全排净70例(90.9%),残留5例,无效2例;部分缘性鹿角形结石完全排净40例(81.6%),残留6例,无效3例;完全缘性鹿角形结石完全排净2例(33%),残留2例,无效2例。结论:低能量ESWL是边缘性鹿角形结石和部分鹿角形结石的首选疗法。因ESWL疗程长,易发生泌尿系统继发感染,完全鹿角形结石不宜单独采用ESWL治疗。采用小间隙电极低能量多次碎石,预防和延缓石街形成,并在石街形成后及时疏通,是提高ESWL治疗边缘性鹿角形结石及部分鹿角形结石成功率的关键。

AIM:To investigate the therapeutic effect of low energetic extracorporeal shock wave lithotripsy(ESWL) and its side effects observed during the treatment for marginal,partial and complete deerhorn like nephrolith. METHODS:A total of 77 patients with marginal,49 with partial and 6 with complete deerhorn like nephrolith in our department were studied retrospectively.Two dimensional KUB examinations were performed 1-2 weeks,1 month,3 months and 6 months after the therapy. RESULTS:Elimination of marginal nephrolith was observed in 70 cases(90.9 %),residual in 5 cases and ineffective in 2 cases.Elimination of partial nephrolith was observed in 40 cases(81.6 %),residual in 6 and ineffective in 3.Elimination of complete deerhorn like nephrolith was observed in 2 cases,residual in 2 and ineffective in 2. CONCLUSION:①Low energetic ESWL could be the first choice for the treatment of properly selected marginal and partial deerhorn like nephrolith.②ESWL is not recommended as the sole therapeutic method for complete deerhorn like nephrolith because of its long therapeutic course,high cost and secondary infection of urinary tract.③Multiple shocks of small inter electrode gap prevent and prolong the formation of stone street or recrack it in time once it formed which is the key of treating deerhorn like nephrolith with ESWL.