低能量体外冲击波碎石对肾鹿角形结石的疗效观察

目的研究低能量体外冲击波碎石 (extracorpreal shock wave lihotripsy,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.

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

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:① Low energetic ESWL could be the first choice for the treatment of properly selected marginal and partial deerhorn- like nephrolith.② ESWL 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.③ Multiple 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.