ESWL术致肾萎缩及其危险因素探讨

The Research of Risk Factor on Atrophyorenal After Extracorporeal Shock Wave Lithotripsy

目的 研究体外冲击波碎石术 (ESWL)致患肾萎缩的危险因素。方法 对 784例ESWL术及 471例开放手术后 5年以上的病人进行了随访调查。比较两组间患肾萎缩发病情况 ,并进行病因学研究。结果 与手术组对照 ,ESWL为一危险因素 ;ESWL组感染因素为潜在危险因素 ;ESWL冲击次数与ESWL治疗次数为高危因素 ;年龄与工作电压对肾萎缩发生率无影响。结论 ESWL治疗为引起患肾萎缩的危险因素。提示临床上使用ESWL治疗肾结石时 ,需严格掌握指征及ESWL的工作条件 ,以防止ESWL后肾萎缩的发生。

Objective To evaluate the risk factor on atrophyorenal after extracorporeal shock wave lithotripsy(ESWL).Methods The follow-up investigate of ESWL treatment group (784 cases) and operation treatment group (471 cases) over 5 years since treated was detected and compared the incidence of atrophyorenal of two groups and researched the etiology. Results ESWL was a risk factor of atrophyorenal compared with operation therapy (relative risk was 2.64 , P<0.05). In ESWL group the infection of renal was a potential risk factor of atrophyorenal(relative risk was 1.8 ,P<0.05 ) . The times of shock and therapy of ESWL were two high risk factors (relative risk separated was 3.22 and 4.88,P<0.05).It was of no evidence the age and working voltage were risk factor in group of ESWL(P>0.05). Conclusion ESWL was a risk factor of atrophyorenal . It shows that the condition for ESWL must be controlled strictly so as to avoid complication.