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1.
低能量体外冲击波碎石术治疗尿路结石4 628例报告 总被引:6,自引:0,他引:6
我院1993年8月~2003年3月,应用CS-2000MP型低能量体外冲击波碎石治疗尿路结石4628例,取得较好的效果,现报告如下。 相似文献
2.
低能量长间距体外冲击波碎石(附380例报告) 总被引:10,自引:0,他引:10
目的:探讨低能量、长间距冲击波技术在体外冲击波碎石(ESWL)中的应用,以及X线、B超双定位技术在ESWL中的优势。方法:应用低能量、长间距冲击波及X线、B超双定位技术进行ESWL380例。结果:380例均获成功,结石排净或残石颗粒直径均〈3mm。所有患者术后都出现轻微血尿,肾结石者12h内消失,输尿管结石者1~2次后消失。58例局部皮肤出现点状红斑。11例形成输尿管石街,经再次ESWL治疗而消失 相似文献
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自2002年1月~2003年12月我院采用Dornier Compact S碎石机低能量治疗上尿路结石450例,效果满意,现报告如下。 相似文献
4.
低能量体外震波碎石机治疗尿路结石132例报告 总被引:6,自引:0,他引:6
目的:探讨低能量体外震波碎石机的治疗效果及其副作用。方法:应用MZ-V型低能量体外震波碎石朵治疗尿路结石132例,治疗工作电压4.5 ̄9.5kV。结果:结石粉碎率为100%。肾结石2个月排净率为98.3%,输尿管结石1.5个月内排净率为98.6%,副作用少,无严重并发症。结论:低能量体外震波碎石机与高能量体外震波碎石机疗效相当,当前者副作用较少且较轻微。 相似文献
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杨志强 《中国中西医结合外科杂志》2010,16(5):610-611
体外冲击波碎石(extracorporeal shock wave lithotripsy,ESWL)治疗尿石症已有20余年历史,因其具有损伤小、可重复性强等特点,至今仍然是尿石症治疗的重要手段。我们于1999—2009年采用ESWL治疗上尿路结石3500例,其中70例(2%)两次碎石不成功,现分析原因如下。 相似文献
8.
复式脉冲低能量体外冲击碎石术治疗上尿路结石(附717例报告) 总被引:17,自引:0,他引:17
目的 探讨复式脉冲HB V型低能量体外冲击碎石术 (ESWL)治疗各种上尿路结石的效果。 方法 采用复式脉冲HB ESWL VG型低能量碎石机治疗符合ESWL适应证的上尿路结石 717例 ,工作电压 3~ 9kV。其中直径≤ 2 .0cm肾结石 4 6 7例 ,平均冲击次数 2 30 0次 ;直径≤ 1.0cm输尿管结石 2 5 0例 ,平均冲击次数 2 80 0次。 结果 上中盏结石排净率 89.5 % (170 / 190 ) ,复打率 13.2 %(2 5 / 190 ) ;下盏结石排净率 81.6 % (16 9/ 2 0 7) ,复打率 17.4 % (36 / 2 0 7) ;肾盂结石排净率 92 .9% (6 5 / 70 ) ,复打率 5 .7% (4 / 70 ) ;输尿管结石总排净率 95 .2 % (2 38/ 2 5 0 ) ,总复打率 6 .4 % (16 / 2 5 0 )。碎石过程中出现轻度疼痛者 10 7例 (14 .9% ) ,治疗后出现肉眼血尿者 6 87例 (95 .8% ) ,1~ 3d后血尿消失。无肾周血肿等严重并发症。 结论 复式脉冲低能量ESWL治疗上尿路结石成功率高 ,复打率低 ,副作用少 ,无严重并发症。 相似文献
9.
目的探讨体外冲击波碎石(extracorporeal shock wave lithotripsy,ESWL)治疗头孢曲松钠所致婴幼儿上尿路结石的疗效。方法2011年6月~2012年6月,我院采用ESWL治疗30例头孢曲松钠所致婴幼儿上尿路结石。结果30例经1次碎石治疗,术后24小时内均有排石,碎石后1周复查泌尿系超声或CT,30例结石全部排出,排净率100%。8例治疗前肾功能受损者均恢复正常。术后肉眼血尿1—4次,均为淡血性。术后门诊B超随访,10例1个月,20例6—12个月,未发现肾包膜下血肿及肾萎缩等严重并发症。结论ESWL治疗头孢曲松钠所致婴幼儿上尿路结石安全有效,可迅速解除尿路梗阻,有效保护肾功能。 相似文献
10.
HB-Ⅴ型低能量碎石机治疗上尿路结石临床报告 总被引:14,自引:2,他引:12
采用HBⅤ型低能量碎石机治疗上尿路结石234例,肾结石粉碎率1000%,两个月内结石排空率810%。输尿管结石粉碎率993%,两周内结石排空率993%,治疗工作电压3~9kV,效果满意,无严重并发症。具有治疗成功率高,复打率低,副作用少之优点 相似文献
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In contrast to the majority of renal calculi, in situ extracorporeal shock wave lithotripsy (ESWL) for upper ureteral stones is still controversial. Some centers recommend retrograde mobilization of the calculus into the renal pelvis prior to ESWL as a routine procedure (UC + ESWL). To evaluate the efficiency of in situ ESWL for upper ureteric stones, we initiated a prospective clinical trial. From July 1985 to January 1986, 122 patients presented with upper ureteral calculi, necessitating a total of 146 different procedures: 88 in situ ESWL; 31 UC + ESWL; 15 antegrade ureteroscopies (URS); 6 retrograde URS; 2 open surgery (ureterolithotomy, nephrectomy), and 4 patients were managed conservatively. Of all 99 patients treated at the lithotripter, 80 patients received in situ ESWL (no emergency case, no location problems): in 60 patients (75%) the stone could be disintegrated in one session; 8 patients (10%) required a second ESWL session due to partial fragmentation. Retrograde mobilization using a ureteral catheter or URS was necessary in 9 patients due to failure of in situ ESWL (11%) and, in only 3 patients, we had to remove the stone by antegrade URS (4%). In conclusion, 96% of all upper ureteric stones suitable for primary ESWL could be treated by a noninvasive (in situ ESWL) or minimally invasive (UC + ESWL) procedure. Therefore we recommend in situ ESWL for these calculi. Primary retrograde mobilization is only indicated in case of location problems (stone close to the spine, obesity, skeleton deformation) or emergency cases (colic, hydronephrosis). Antegrade URS should be performed if retrograde mobilization fails or in emergency cases (acute pyelonephritis, following percutaneous nephrostomy, after clinical stabilization). The rate of open surgery is below 2%. 相似文献
12.
In situ extracorporeal shock wave lithotripsy for upper ureteral stones: Experience with 65 patients
A total of 65 patients with 67 upper ureteral stones underwent in situ extracorporeal shock wave lithotripsy (ESWL) between
March 1990 and September 1990. For stone disintegration the electrohydraulic shock wave lithotripter Tripter XI (Direx) was
used. Eighty-seven per cent of stones showed satisfactory disintegration after the first treatment and a further 9 per cent
after repeat treatments. The stone-free rate at 12 weeks was 85 per cent. General anaesthesia was needed in only 12 per cent
of patients. The retreatment rate was 13 per cent.
It was concluded that in situ ESWL is an effective procedure with negligible morbidity for treating upper ureteral stones. 相似文献
13.
H Ushida M Maegawa S Maekawa K Inoue Y Kaneko K Ohmori K Nishimura 《Hinyokika kiyo. Acta urologica Japonica》2001,47(10):709-713
Between August 1999 and July 2000, 123 cases of renal stones and 52 cases of ureteral stones in 116 males and 59 females were treated with the New Piezolith 2500. The average number of sessions required for renal and ureteral stones was 2.50 and 1.48, respectively. At 3 months postoperatively, stone-free rates for renal and ureteral stones were 64.2% and 72.7%, respectively. Assessing residual stones less than 4 mm in diameter as an effective treatment outcome, the efficacy rates for renal and ureteral stones were 94.3% and 86.4%, respectively. Side effects were encountered in 5 cases (2.9%) of high fever and one case (0.57%) of renal subcapsular hematoma. New Piezolith 2500 is effective and safe for the treatment of upper urinary stones. 相似文献
14.
Treatment strategy for piezoelectric shock wave lithotripsy of upper ureteral calculi. 总被引:1,自引:0,他引:1
T Creagh M Gleeson R Grainger T E McDermott M R Butler 《The Journal of urology》1992,147(6):1499-1501
In situ piezoelectric lithotripsy monotherapy for upper ureteral stones is an attractive option because it can be conducted on an outpatient basis. Difficulty in calculus localization with ultrasound is the limiting factor. We reviewed our experience with 99 patients treated for upper ureteral calculi with the EDAP LT.01 lithotriptor. For stones above the lower renal border we achieved a 53% stone-free rate compared to 25% for calculi below the lower renal border. In situ piezoelectric lithotripsy of upper ureteral calculi may be considered for stones above the lower renal border. 相似文献
15.
J E Lingeman W L Shirrell D M Newman P G Mosbaugh R E Steele J R Woods 《The Journal of urology》1987,138(4):720-723
The results of 471 extracorporeal shock wave lithotripsy treatments in 465 patients with solitary ureteral stones managed by several different techniques are reported. In situ treatment was performed in 123 cases without instrumentation and in 47 after placement of a ureteral catheter. Retrograde stone manipulation was performed in 245 cases immediately before extracorporeal shock wave lithotripsy and an additional 56 were manipulated with ureteral stent placement at least 1 week before extracorporeal shock wave lithotripsy. The success rate was significantly greater if the stone was manipulated into the kidney before extracorporeal shock wave lithotripsy. Significantly less energy (p less than 0.0001) was required for complete disintegration if the stone was free floating in the kidney. The need for subsequent procedures was significantly less (p less than 0.0001) for stones manipulated successfully into the kidney. Complications were infrequent, with the most common being ureteral perforation in 5.1 per cent of the cases, all of which were managed conservatively. Extracorporeal shock wave lithotripsy is the treatment of choice for proximal ureteral calculi because it is less morbid than percutaneous approaches and provides significantly better results than ureteroscopy. An attempt at manipulation of proximal ureteral calculi back into the kidney should be made before extracorporeal shock wave lithotripsy. 相似文献
16.
Two main mechanisms govern the field of laser lithotripsy. The first mechanism produces mechanical stress inside the stone
by absorbing the laser light at the stone surface. Therefore it depends on the stone's optical properties. The second method
uses a Q-switched laser and an energy converter to release mechanical shock waves acting on the stone to cause its fragmentation.
This method is called laser-induced shock wave lithotripsy (LISL). The converter must be attached to the light transmitting
optical fibre and should not provide an increase of the overall diameter of the probe to fit in a small, flexible endoscope.
So we used the irrigation liquid, which must be supplied for endoscopic lithotripsy. Adding of Fe3+-ions to the isotonic saline solution (0.02 mmol l−1) lowered the intensity threshold for the energy conversion. With this special irrigation liquid we have a continuously regenerating
energy converter. It allows the use of bare fibres with spherically shaped tips, which can be easily changed while the endoscope
remains inside the patient's body. 相似文献
17.
H G Tiselius 《The Journal of urology》1991,146(1):8-12
Stones in the proximal, mid and distal ureter in 375 consecutive patients were treated with extracorporeal shock wave lithotripsy (ESWL) in a technically unmodified Dornier HM3 lithotriptor without regional or general anesthesia. Adequate followup was available in 162 patients with proximal, 62 with mid and 146 with distal ureteral stones. The fraction of patients with stone-free ureters within 3 months after ESWL was 96, 97 and 97%, respectively. Of all patients only 13 (3.6%) had residual stones or fragments in the ureter after 3 months. The average number of ESWL sessions was 1.34 for all patients, and 1.36, 1.45 and 1.38 for those with proximal, mid and distal ureteral stones, respectively. A ureteral catheter with saline irrigation was used whenever it was possible to insert a ureteral catheter. Only 15 stones were pushed up to the kidney during catheterization and all other stones were treated in situ. There were more retreatments in patients in whom the stone had not been bypassed by a catheter at the initial ESWL session. During at least 1 treatment session 238 patients had a ureteral catheter with the tip above the stone. Approximately half of all patients were treated after only premedication with pethidine and diazepam, and cutaneous half of all patients were treated after only premedication with pethidine and diazepam, and cutaneous anesthesia with an anesthetic cream containing lidocaine-prilocaine (for proximal and mid ureteral stones). Small supplements of pethidine and diazepam were given to the other patients during the ESWL session. In situ ESWL of ureteral stones as described is a convenient, efficient and attractive procedure that, applied in a consequent manner, theoretically might result in a successful outcome in up to 98% of the patients. 相似文献
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In vitro comparison of shock wave lithotripsy machines 总被引:3,自引:0,他引:3
Teichman JM Portis AJ Cecconi PP Bub WL Endicott RC Denes B Pearle MS Clayman RV 《The Journal of urology》2000,164(4):1259-1264
PURPOSE: We tested the hypothesis that shock wave lithotripsy machines vary in the ability to fragment stones to small size. MATERIALS AND METHODS: Calcium oxalate monohydrate, calcium hydrogen phosphate dihydrate, cystine and magnesium ammonium phosphate hexahydrate calculi were fragmented in vitro with the 22 kV. Dornier HM3, section sign 20 kV. Storz Modulith SLX, parallel, 15.6 kV. Siemens Lithostar C, paragraph sign 24 kV. Medstone STS-T,** 26 kV. HealthTronics LithoTron 160,daggerdagger 20 kV. Dornier Doli section sign and 22.5 kV. Medispec Econolithdouble daggerdouble dagger lithotriptors. Stones were given 500 or 2,000 shocks, or the Food and Drug Administration limit. Post-lithotripsy fragment size was characterized using sequential sieves and compared. RESULTS: Stone mass was statistically similar in the cohorts (p >0.94). Fragment size decreased as the number of shocks increased when the machine and stone composition were constant. Magnesium ammonium phosphate hexahydrate calculi were completely fragmented by all devices. At Food and Drug Administration treatment limits the mean incidence per device of calcium hydrogen phosphate dihydrate, calcium oxalate monohydrate, cystine and magnesium ammonium phosphate hexahydrate stones rendered into fragments greater than 2 mm. was 0% for the HM3, Modulith SLX and Lithostar C, 10% for the STS-T, 3% for the LithoTron 160, 29% for the Doli and 18% for the Econolith (p = 0. 04); 0% for the HM3, Modulith SLX, Lithostar C, STS-T and LithoTron 160, 4% for the Doli and 9% for the Econolith (p = 0.15); 1% for the HM3, 0% for the Modulith SLX, 1% for the Lithostar C, 10% for the STS-T, 14% for the LithoTron 160, 3% for the Doli and 9% for the Econolith (p = 0.44); and 1% for the HM3, 0% for the Modulith SLX, 1% for the Lithostar C, 10% for the STS-T, 14% for the LithoTron 160, 3% for the Doli and 9% for the Econolith (p = 0.44), respectively. CONCLUSIONS: Shock wave lithotriptors vary in fragmentation ability. The HM3, Modulith SLX and Lithostar C machines yield smaller fragments than other machines. 相似文献
20.
Three hundred and sixteen patients with ureteral stones were treated in situ (without retrograde stone manipulation) with and without stent bypass (DJ stent, ureteral catheter). Results were generally better with stent bypass, but only marginally so for stones larger than 10 mm in diameter. Regardless of whether or not the ureter was stented, lower ureteral stones were more difficult to fragment than upper ureteral stones and pre-sacral stones did not respond well to in situ treatment. We observed that evaluation of stone disintegration and fragment evacuation could only be properly assessed after approximately 3 weeks post-ESWL. 相似文献