体外冲击波碎石治疗不同术式术后残留肾结石的疗效

目的：观察体外冲击波碎石（ESWL）治疗不同术式术后残留肾结石的疗效。 方法：回顾性分析2006年5月至2008年5月采用ESWL诊治100例不同术式术后残留肾结石患者的排净率，其中经尿道输尿管镜激光碎石术后15例（Ⅰ组），经尿道输尿管镜气压弹道碎石术后25例（Ⅱ组），经皮肾输尿管镜钬激光碎石术后11例（Ⅲ组），经皮肾输尿管镜气压弹道碎石术后12例（Ⅳ组），肾切开取石术后37例（Ⅴ组）。结果：100例术后残留肾结石患者经ESWL治疗后总的结石粉碎率为94.0%，排净率为86.0%。其中Ⅰ组结石排净率为100.0%，Ⅱ组结石排净率为100.0%，Ⅲ组结石排净率为81.8%，Ⅳ组结石排净率为83.3%，Ⅴ组结石排净率为73.0%，Ⅰ+Ⅱ组结石排净率高于Ⅲ+Ⅳ组及Ⅴ组（P<0.05）。结论：术后残留肾结石行ESWL治疗效果好，尤其是经尿道输尿管镜术后残余肾结石碎石效果最好。

Effect of extracorporeal shock-wave lithotripsy on residual stones after different methods of surgery

Objective To observe the effect of extraeorporeal shock wave lithotripsy (ESWL) on residual stones after different methods of surgery. Methods Clinical resources of 100 patients with residual stones after different methods of surgery treated with extracorporeal shock wave lithotripsy from May 2006 to May 2008 were retrospeetively studied. Of the 100 patients, ureteroscopic laser lithotripsy was used for 15 patients (Group Ⅰ) , ureteroscopic pneumatic lithotripsy was used for 25 (Group Ⅱ), mini-percutaneous nephrolithotomy (MPCNL) with holmium laser for 11 (Group Ⅲ), mini-percutaneous nephrolithotomy (MPCNL) with airpressure path lithotripterfor 12 (Group Ⅳ) , open surgery for the other 37 (Group Ⅴ). Results About 94% of the residual stones were shattered, and 86 % of the residual stones were cleared successfully. The clearance rate of residual stones from Group Ⅰ to Ⅴ was 100% , 100% , 81.8% , 83.3% , and 73.0% , respectively. The clearance rate of residual stones in Group Ⅰ + Ⅱ was higher than that of Group Ⅲ + Ⅳ and Group V (P<0.05). Conclusion Extracorporeal shock wave lithotripsy is good for the treatmentof residual stones after different methods of surgery, especially the management of residual stones after trans-urethral ureteroscope technique.