低能量ESWL治疗上尿路结石1020例临床分析

目的:观察低能量体外冲击波碎石治疗上尿路结石的疗效及并发症。方法:应用MZ-V型低能量碎石机治疗上尿路结石1020例。结果:1020例结石均被粉碎,排石成功率为99.12％,无1例发生严重内脏损伤。结论:低能量碎石机具有碎石成功率高,无需镇痛,无严重并发症等优点,是目前治疗上尿路结石的理想方法。     

B超定位低能量ESWL治疗尿路结石4512例报告

目的：探讨B超定位低能量体外冲击波碎石术（ESWL）治疗尿路结石的优势、技术特点、治疗效果与副作用。方法：采用WD－ESWL－91型B超定位体外冲击波碎石机治疗尿路结石4512例,冲击电压10－12kV,平均 冲击次数2500次。结果：总碎石成功率为98．8％,3个月结石排净率为83．5％。结论：B超定位低能量ESWL具有定位准确、成功率高、组织损伤小、无严重并发症等特点,特别是尿路阴性结石患者,B超定位更具有独到之处,值得推广。     

低能量体外震波碎石机治疗尿路结石132例报告

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。     

128例低能量体外冲击波碎石原位治疗上尿路结石

目的 探讨低能量体外冲击波碎石机治疗上尿路结石的疗效及副作用。方法 应用银星TS-153C型碎石机原位治疗肾、输尿管结石128例。结果 肾结石碎石率98.7％,2个月内排净率93.7％;输尿管结石碎石率98.9％,2周内排净率94.4％。并发症:肾破裂1例,占0.78％;肾积脓合并无尿1例,占0.78％,其余并发症均轻微。结论 低能量碎石机治疗上尿路结石获得满意疗效,正确掌握适应证是提高EWSL疗效及预防严重并发症的关键。     

HB—V型低能量碎石机治疗上尿路结石临床报告

采用ＨＢ－Ｖ型低能量碎石机治疗上尿路结石２３４例，肾结石粉碎率１００．０％，两个月内结石排空率８１．０％。输尿管结石粉碎率９９．３％，两周内结石排空率９９．３％，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。     

复式脉冲碎石机治疗儿童上尿路结石

目的探讨低能量复式脉冲碎石机对儿童上尿路结石治疗的可行性。方法采用国产BH-VG低能量复式脉冲碎石机治疗儿童上尿路结石21例，男童11例，女童10例；学龄前儿童（2-7岁）13例；学龄期儿童（8-16岁）8例。肾结石每次治疗不超过2500次，治疗电压3-7．5kV；输尿管结石每次治疗不超过3500次，治疗电压4-8kV。结果肾结石粉碎率100％，两周内结石排空率100％；输尿管结石粉碎率100％，两周内结石排空率100％。结论低能量复式脉冲碎石机治疗儿童上尿路结石是一种安全、有效的治疗方法。     

HB-Ⅴ型低能量碎石机治疗上尿路结石临床报告

采用ＨＢⅤ型低能量碎石机治疗上尿路结石２３４例，肾结石粉碎率１０００％，两个月内结石排空率８１０％。输尿管结石粉碎率９９３％，两周内结石排空率９９３％，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     

腔内镜联用配合气压弹道碎石治疗复杂性上尿路结石

目的：探讨提高复杂性上尿路结石疗效的方法。方法：对21例复杂性上尿路结石患者采用经皮肾镜、输尿管镜、输尿管电切镜两镜或三镜联合并配合气压弹道碎石机治疗。结果：21例复杂性上尿路结石均一期治疗成功，一期结石取净率为90．5％，3个月结石排净率为100%，无严重并发症发生。结论：腔内镜联用配合气压弹道碎石治疗复杂性上尿路结石具有安全、高效、损伤小、周期短等优点。     

ESWL治疗上尿路结石3060例总结

ＥＳＷＬ治疗上尿路结石３０６０例总结符庆吉刘悦王越郑洪柱安京顺郑淑梅自１９８８年８月～１９９５年７月，应用ＷＤ－ＥＳＷＬ９１型Ｂ超定位体外冲击波碎石机治疗上尿路结石３０６０例，配合输尿管镜术（ＵＲＳ）和中西医排石疗法，结石排净率达９９．１％。总结如下...     

经皮肾穿气压弹道碎石联合体外冲击波碎石治疗上尿路结石

目的 探讨提高上尿路结石碎石成功率的微创治疗方法。方法 采用经皮肾穿微造瘘输尿管镜气压弹道碎石，术中放置双J管，术后配合体外冲击波碎石术(ESWL)治疗上尿路结石48例。结果 结石总排净率为89．1％，结石最小排净率79．2％，无严重并发症发生。结论 该方法结石排净率高，创伤较小，手术并发症少，是上尿路结石较为理想的微创治疗方法。     

Clinical application of Sonolith 2000 type B on extracorporeal shock wave lithotripsy for upper urinary tract calculi

This report describes the results of clinical trials of the second generation extracorporeal shock wave lithotriptor (Sonolith 2000 Type B) in patients with upper urinary tract stones. The studies were carried out on 101 cases at the Departments of Urology, Juntendo University School of Medicine, Kanto Teishin Hospital and General Daiyukai Hospital from Nov. 1987 to Jun. 1988. The location of stones were renal calyx and pelvis in 84 cases, ureteropelvic junction in 7 cases and upper ureter in 12 cases (2 of them had multiple stones at different levels). The average number of treatment per a patient was 1.25, and that of shock waves delivered per treatment was 1798. Ultrasound localization has been effective in all cases. The rate of destruction of the stones was 100% in the kidney, 66.7% in the upper ureter, with an overall average of 95.0%. On the X-ray film obtained six weeks after ESWL treatment, the stone free rate was 53.5%, and the effectiveness rate was 89.1%, including the cases of stone free and cases with fragments smaller than 5 mm. No serious adverse effect was observed, although there were mild transient hematuria in all cases and pyrexia (more than 38.0 degrees C) in 7 cases (6.9%). The procedure was performed safely in the majority of patients without anesthesia. In 10 cases, we applied anesthesia (epidural anesthesia in 3 cases, and local anesthesia in 7 cases) for the prevention of pain. It is concluded that ESWL treatment using Sonolith 2000 Type B is as effective as other types of shock wave lithotriptor previously applied to urolithiasis without serious clinical complication.     

体外冲击波碎石术治疗上尿路尿酸结石

作者采用超声定位的压电晶体式体外冲击波碎石术连续性治疗１２１例上尿路尿酸结石，观察其碎石疗效。肾结石１１２例，共１６７枚，结石长径０．５～３．５ｃｍ，平均０．８６ｃｍ；输尿管结石９例，长径０．６～１．３ｃｍ，平均０．８４ｃｍ。２例输尿管上段结石接受了重定位辅助治疗，其余均采用原位治疗。单次治愈者为８０．９９％，２次者１２．４０％，３次者４．９６％，４次者１．６５％。所有患者术后均未发生严重并发症。作者认为采用超声定位的压电晶体式碎石机治疗尿酸结石是一种较为理想的方法，并侧重探讨了尿酸结石的Ｂ超定位技术、碎石过程中的冲击方法和术后碱性药物的应用。     

输尿管肾镜气压弹道碎石术治疗输尿管膀胱尿道结石(附152例报告)

目的：探讨输尿管肾镜气压弹道碎石术治疗输尿管、膀胱、尿道结石的疗效与安全性。方法：回顾性分析经尿道输尿管肾镜气压弹道碎石术治疗的152例尿道、膀胱、输尿管结石患者的临床资料。结果：4例男性尿道结石和20例膀胱结石均碎石成功，输尿管中下段结石109例，107例成功，2例输尿管口狭窄改用ESWL碎石成功；输尿管上段结石19例，12例原位碎石成功，2例输尿管镜插至输尿管中段上行受阻插管改ESWL碎石成功，5例部分碎石冲入或推入肾内置引流管后行ESWL碎石成功。结论：输尿管肾镜气压弹道碎石术治疗输尿管及其以下尿路结石，具有安全可靠、损伤小、术后恢复快等优点，是微创治疗的有效方法之一。对于输尿管上段结石，将该手术配合ESWL也能取得满意疗效。     

Experience in 3,500 patients with urinary stones treated with the Dornier HM-4 bath-free lithotriptor

During a 3-year period, hundreds of patients underwent ESWL treatment with the Dornier HM-3 and HM-4 lithotriptors operating at our institution. Our experience in 3,500 patients treated with the HM-4 bath-free lithotriptor is reported. Patients with radiolucent or cystine stones, stones larger than 3 cm or staghorn calculi, multiple stones with a total burden of more than 3 cm and those not amenable to follow-up were excluded from the study. The overall stone-free rate was 70.7% and 81% at 1 and 3 months, respectively. The stone-free rates at 1 and 3 months were further determined by the exact location of each stone within the urinary tract. Stone-free rates at 3 months ranged from 90.84% for renal pelvic stones to 71.08% for lower calyceal stones, while the stone-free rates for ureteral calculi ranged from 80.85% for upper third unstented ureteral stones to 92.92% for lower ureteral stones. The overall complication rate was 6.02% with a 1.2% post-ESWL intervention rate (ureteroscopy or placement of percutaneous nephrostomy or stent).     

The impact of the Dornier Compact Delta lithotriptor on the management of primary ureteric calculi

OBJECTIVE: To assess the effectiveness of the Dornier Compact Delta lithotriptor on the management of in situ primary ureteric stones. PATIENTS AND METHODS: 137 patients with primary ureteric stones were treated at a tertiary urological center using the latest Dornier Compact Delta lithotriptor between January 1999 and January 2002. Effectiveness of lithotripsy, retreatment rate, reasons for failure and complications were assessed. RESULTS: 102 males and 35 females with primary ureteric stones underwent ESWL treatment at our center. 74 patients had upper, 37 middle and 26 lower ureteric locations respectively.Mean stone size was 10 mm (range 8-25 mm). Mean numbers of sessions required were 1.8 (range 1-3). The retreatment rate was 33% in upper ureteric, 29% in mid ureteric and 26% in lower ureteric locations respectively. Complete clearance rate at 3 months was 86% for upper ureteric, 79% for mid ureteric and 79% for lower ureteric. 29 patients had auxiliary treatment in the form of double J ureteric stenting or percutaneous nephrostomies. 26 patients failed treatment and underwent ureteroscopic or ante grade percutaneous removal. Stone size was the only significant factor correlating with failure. The mean size of stones in the successful group was 12 mm as compared to 17 mm in failure group. The likelihood of success following a failed second session (no disintegration or disintegration with fragments more than 6 mm) of treatment was 13.4%. Complications including, steinstrasse, colic, UTI and petechial haemorrhage were seen in 35 patients. One patient developed pyonephrosis and subsequently required nephrectomy. CONCLUSION: An electromagnetic shock wave lithotriptor using the EMSE-150 shock wave emitter is an effective in situ treatment of primary ureteric stones. Patients with large stone size are likely to have a higher retreatment rate, more auxiliary procedures and complications. Having a failed second treatment session, the likelihood of a successful outcome after third session of ESWL is poor.     

Treatment of staghorn calculi by extracorporeal shock-wave lithotripsy in children]

To evaluate the efficacy of monotherapy with extracorporeal shock-wave lithotripsy (ESWL) for staghorn calculi in children. Material and methods: Between September 1987 and December 1998, 27 children (18 boys and 9 girls) with a mean age of 5.2 years (9 months to 147 years) were managed in our department for staghorn or pseudo-staghorn calculi. They were treated with a Lithostar Siemens-Ultra lithotriptor ith ultrasound detection. The "Puigvert method", which starts with low energy which is then gradually increased, allows satisfactory painless fragmentation, avoiding the need for general anaesthesia. RESULTS: the success rate was 70% with two sessions (37% with a single session). In one case, lithotripsy was not indicated and percutaneous nephrolithotomy was necessary. Two cystine stones ina girl (probably longstanding stones) could not be fragmented and open surgery was required. The other five systine staghorn calculi ere treated successfully. Ureteral catheterization was not required and only one double J stent was placed preventively in a girl with a solitary kidney. No major complication was detected. CONCLUSION: ESWL with the Siemens-Ultra lithotriptor is a safe and effective first-line method for the treatment of staghron calculi in children.     

Two years clinical experiences with extracorporeal shock-wave lithotripsy and transurethral ureterolithotripsy for ureteral stones at Osaka City University Hospital

From July 1985 to June 1987, 303 patients with ureteral stones were treated by either extracorporeal shock-wave lithotripsy (ESWL) or transurethral ureterolithotripsy (TUL). The ureteral stones were classified into two groups, upper and lower ureteral stones. The upper ureteral stone was defined as a stone located above the pelvic brim in radiological examinations. ESWL was performed using a Dornier lithotriptor HM-3. For TUL, following the insertion of a guide wire and dilatation of the intramural ureter by ureteral bougie, a ureteroscope was introduced into the ureter. The success rate included both patients who became stone free and patients whose stones were disintegrated into less than 4 mm. The success rate of ESWL for upper ureteral stones was 90%, and 8.5% were treated subsequently by TUL. The success rate of TUL for upper ureteral stones was 42%, and the remaining required another session of TUL or another procedure, mainly ESWL. On the other hand, the success rate of TUL for lower ureteral stones was 71%, and the remainder also required another session of TUL or another procedure, mainly ESWL. The efficacy of TUL for stone street was comparably low by the evaluation done at 5 days after the procedure. However, almost all patients with stone street, which had developed after ESWL treatment, became stone free several weeks after TUL and insertion of a stent catheter. Major complications or side effects for ESWL were fever of more than 37.5 degrees C (7.5%) and pain attacks (8.9%).(ABSTRACT TRUNCATED AT 250 WORDS)     

电磁式碎石机治疗输尿管结石的疗效观察

目的:探讨使用电磁式碎石机治疗输尿管结石的疗效。方法:2000年12月～2005年5月,应用德国电磁式碎石机治疗输尿管结石946例,并进行随访。结果:首次碎石有效率83%,第二次治疗有效率11%,3个月内结石清除率为95%。未见明显并发症。结论:电磁式体外冲击波碎石机治疗输尿管结石具有能量低,易于定位,损伤小及碎石颗粒均匀细小等优点,应作为输尿管结石治疗的首选方法之一。     

Extracorporeal shock wave lithotripsy in the management of pediatric urolithiasis

The main objective of this paper was to evaluate the efficacy and safety of the management of pediatric urolithiasis by extracorporeal shock wave lithotripsy (ESWL). Between November 1988 and July 2000, 165 renal stones, 53 ureteral stones, and 5 bladder stones were treated in 126 pediatric patients using Siemens Lithostar lithotriptor. The ESWL treatments ranging from 1 to 7 were needed per patient (mean: 2.1). One ESWL session was performed for 49.6% of stones, two for 24.6%, three for 13.0 %, four for 5.6% and > 4 for 8.2%. The success rate for renal stone units (asymptomatic fragments less than 4 mm) was 88.2%, stone-free rate was 49.0%. The stone-free rate for ureteral stone units was 87.5%, but was 75% for bladder stones. The overall results of ESWL treatment in 126 children was satisfactory: the success rate was 90.5%, stone-free rate was 51.6%, residual fragments > 4 mm were 9.5%. General anesthesia was required in 65 children (136 treatments) under the age of 10, and only in 18 children (40 treatments) in the age 11–14. Auxiliary procedures, such as double J stent and percutaneous nephrostomy (PCN) were used in 19 and 7 patients, respectively. Perirenal hematoma in one patient and hematomas in enteric wall in another one patient were the only major complications managed conservatively without consequences. Low energy lithotripsy with the Siemens Lithostar in our series of pediatric patients was safe and relatively effective.     

Extracorporeal shock wave lithotripsy for ureteral calculi.

Second generation tubless lithotriptors allow for easy prone positioning of patients, resulting in increased use of extracorporeal shock wave lithotripsy (ESWL) for calculi in the ureter, especially in the mid and lower third portions. The 3-month stone-free rate with single stones using a Dornier HM3 and a Medstone STS lithotriptor in the upper ureter was 79% (316 patients) and 81% (188), respectively, while in the mid ureter it was 60% (20 patients) and 81% (32), respectively, and in the lower ureter it was 80% (5 patients) and 85% (26), respectively. The retreatment rate with single stones using the Dornier HM3 and the Medstone STS devices was 5% and 4%, respectively, in the upper ureter, 13% and 12%, respectively, in the mid ureter, and 0% and 5%, respectively, in the lower ureter. The second procedure rate after ESWL with single stones using the Dornier HM3 and the Medstone STS units was 6% and 6%, respectively, in the upper ureter, 15% and 16%, respectively, in the mid ureter, and 0% and 17%, respectively, in the lower ureter. Expectant management is still an acceptable method to treat small ureteral stones, and it is questionable whether ESWL is the appropriate treatment for lower third ureteral stones compared to equally effective and less expensive ureteroscopy.