Current status of extracorporeal shock wave lithotripsy

Summary Extracorporeal shock wave lithotripsy (ESWL) is standard therapy for urolithiasis. With comparable technical principles, various lithotripters have been developed and are in routine use. Renal pelvic stones, calyceal stones, ureteral stones, and other special forms can be treated with varying results. Currently, the so-called clinically insignificant residual fragments and the recurrence of calculi are under discussion. Whereas the side effects of ESWL are well known, studies comparing ESWL with other endourological procedures are still lacking.      

输尿管膀胱壁段结石的治疗

目的观察比较输尿管镜下钬激光碎石术和体外冲击波碎石术（ESWL）治疗输尿管膀胱壁段结石的临床疗效。方法64例输尿管膀胱壁段结石患者,34例采用ESWL治疗,30例采用钬激光碎石术治疗。结果钬激光碎石术治疗输尿管膀胱壁段结石有效率为100％,明显高于ESWL组的58．8％。结论输尿管镜下钬激光碎石术治疗输尿管膀胱壁段结石安全有效,成功率高,并发症少,是首选的治疗方法。     

体外冲击波碎石联合中药治疗泌尿系结石效果观察

目的探讨体外冲击波碎石（ESWL）联合中药治疗泌尿系结石的疗效和安全性。方法选择2008-02～2011-02在该院住院的泌尿系结石患者138例随机分为治疗组（70例）和对照组（68例）,治疗组行ESWL联合中药治疗,对照组单独行ESWL治疗,对比分析两组的结石清除率和术后情况。结果138例结石患者结石清除均获成功,无严重并发症发生。治疗组结石清除率、术后止痛药应用率、发热率以及住院时间与对照组比较差异有统计学意义（P〈0．05）。结论ESWL联合中药治疗泌尿系结石,能有效清除各类结石,明显提高ESWL手术效率,值得临床推广应用。     

泌尿系结石体外震波碎石术600例临床护理体会

目的探讨体外震波碎石术的护理方法。方法对600例泌尿系结石行体外震波碎石术治疗的患者,给予术前、术中、术后细致的心理护理及健康指导。结果全部患者无碎石恐惧感,顺利接受碎石治疗,并逐渐排出结石。结论对泌尿系结石体外震波碎石术患者进行细致的护理及健康指导,可使患者积极主动配合治疗及调整饮食结构,促进排石及预防再次发生结石。     

超声定位体外冲击波碎石术治疗输尿管结石

目的 探讨体外冲击波碎石技术在输尿管结石治疗中的价值。方法 对752例输尿管结石进行超声检查诊断，其中696例在实时超声引导下用冲击波碎石治疗。结果 经超声定位体外冲击波治疗输尿管结石的总有效率为97．8％。结论 体外冲击波碎石是治疗输尿管结石的首选方法，技术的熟练和操作的适当可改善疗效。     

中药配合X线定位体外冲击波碎石治疗单发输尿管结石

目的观察自拟排石方配合X线定位体外冲击波碎石治疗半发输尿管结石的．;I亍效。万法70例旱发输尿管结石患者随机分成治疗组和对照组。治疗组碎石后给予我院自拟中药排石方（药用海金砂、金钱草、石韦、车前子等）,对照组给予1：7服坦洛新缓释片,以14d为1个疗程,进行疗效观察。结果2组临床疗效比较：治疗组总有效率94．3％,对照组总有效率74．3％,2组比较,P〈0．05;治疗组无明显不良反应,对照组出现2例体位性低血压。结论中药配合体外冲击波碎石治疗输尿管结石可扩张输尿管,减少输尿管痉挛,有利于结石排出,减少不良反应。     

肾结石治疗方法随机对照试验的Meta-分析

目的 客观评价体外冲击波碎石术、经皮肾穿刺造瘘碎石取石术治疗肾结石的疗效。方法 采用电子检索和手工检索进行文献初检,电子检索数据库有Medline data-base（1980年1月-2006年6月）、中国期刊全文数据库（CNKI,1980年1月-2006年6月）、中国循证医学/Cochrane中心数据库（CEBM/CCD）、Cochrane图书馆,手工检索近期《中华泌尿外科杂志》等4种杂志,鉴定有关随机对照试验,并采用RevMan4.2进行Meta-分析。结果 我们共收集纳入2个随机对照试验进行了结石清除率的比较,177例病人符合纳入标准,Meta-分析结果显示经皮肾穿刺造瘘碎石取石术治疗肾结石（直径〈3cm）在结石清除率方面明显高于体外冲击波碎石术。结论 经皮肾穿刺造瘘碎石取石术治疗肾结石方面显示出了巨大的优势。     

Mechanisms of shock wave induced endothelial cell injury

BACKGROUND AND OBJECTIVES: Medical procedures, for example, laser angioplasty and extracorporeal lithotripsy as well as high-energy trauma expose human tissues to shock waves (SWs) that may cause tissue injury. The mechanisms for this injury, often affecting blood vessel walls, are poorly understood. Here we sought to assess the role of two suggested factors, viz., cavitation or reactive oxygen species (ROS). STUDY DESIGN/MATERIALS AND METHODS: A laser driven flyer-plate model was used to expose human umbilical cord vein endothelial cell (HUVEC) monolayers to SWs or to SWs plus cavitation (SWC). Cell injury was quantified with morphometry, trypan blue staining, and release of (51)Cr from labeled HUVECs. RESULTS: HUVECs, exposed to SWs only, could not be distinguished from controls in morphological appearance or ability to exclude trypan blue. Yet, release of (51)Cr, indicated a significant cell injury (P < 0.05). HUVEC cultures exposed to SWC, exhibited cell detachment and cell membrane damage detectable with trypan blue. Release of (51)Cr was fourfold compared to SW samples (P < 0.01). Signs of cell injury were evident at 15 minutes and did not change over the next 4 hours. No protective effects of ROS scavengers were demonstrated. CONCLUSIONS: Independent of ROS, SWC generated an immediate cell injury, which can explain, for example, vessel wall perturbation described in relation to SW treatments and trauma.     

低能量ESWL治疗尿路结石

目的:探讨低能量体外冲击波碎石术(ESWL)治疗尿路结石的疗效、技术特点和副损伤。方法:普通B超定位、低能量(冲击电压3.7~6.3 kV)体外冲击波碎石术治疗各段尿路结石500例,冲击次数600~2 900次。结果:单序列冲击成功率为64.2%,总碎石成功率89.5%,再次碎石率32.6%。结论:B超定位低能量ESWL具有定位方便,成功率较高、无严重并发症、组织损伤轻微等特点,有一定的应用价值。     

体外冲击波碎石治疗肾结石356例临床分析

目的探讨体外冲击波碎石(ESWL)治疗肾结石的效果和体会。方法回顾性分析ESWL治疗的356例肾结石病人。结果经ESWL治疗的356例肾结石病人中,302例在1年内排尽结石,43例残留结石,11例碎石无效。结论ESWL是治疗肾结石的首选方法,安全有效,易被患者接受,但要注意病例的选择。