不同体位在ESWL治疗输尿管上段结石的疗效中的影响

目的 探讨体位（仰卧位和俯卧位）是否影响ESWL治疗输尿管上段结石的治疗效果。方法对2005年3月～2006年12月输尿管上段结石病人136例随机分为两组行ESWL治疗，行仰卧位治疗组70例（组1），俯卧位治疗组66例（组2）。术前行IVU和KUB检查定位，记录每个病人从治疗到无石过程的结石大小、治疗次数、每次治疗的冲击次数。结果达到无石的治疗次数两组接近，仰卧位组（1．9±0．8）和俯卧位组（1．8±0．7），（P=0．78）。每次治疗的平均冲击波次数二者差别不大，仰卧位组（3055．1±346.3）和俯卧位组（3137．5±621．0），（P=0．95）。ESWL后总共有112例（82．5％）病人达到了无石；其余的24例（17．5％）不能排除结石。仰卧位组的排石率为82％，俯卧位组的排石率为83％。两组排石率没有统计学差异（P=0．90）。两组的并发症都很少．仅有轻微的血尿，尿急，尿痛，和腰痛，口服药物后均可缓解。结论对于ESWL治疗输尿管上段结石来说，俯卧位和仰卧位同样安全有效。

Effective comparison between different body positions on ESWL for treatment of proximal ureteral stones

Objective To investigate the body position whether playing significant role on the treatment of stones in the proximal ureter with extracorporeal shock wave lithotripsy （ESWL）. Methods 136 patients with proximal ureteric stones underwent ESWL. The procedure was performed in the supine position in 70 （Group 1） and the prone position in 66 patients （Group 2）. The IVU and KUB examination were performed to localization before operation. The stone size ,therapeutic times and shock times in every treatment were recorded. Results The mean numbers per patient were similar in two groups, （1.9±0.8） in Group 1 and （1.8±0.7） in Group 2 （P=0.78） respectively. Also, the numbers of shocks per time were similar, 3055.1±346.3 in Group 1 and 3137.5±621.0 in Group 2（P=0.95）, respectively. The stone-free rates were 82% in Group 1 and 83% in Group 2（P=0.95） within three months after ESWL. Lithagogue rate was no statistcal difference in two groups（P=0.90）. There were little complications in two groups which can be released by taking medicines. Conclusion ESWL is safe and effective on prone and supine position for the treatment of proximal ureteral stones.