体外冲击波碎石术治疗肾结石成功的预后因素分析。

M. A. Zaman, Jamal E Rabby, M. Ali, Kabirul Hassan, M. M. Rahman, Atm Ashaduzzaman
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引用次数: 0

摘要

背景:肾结石很常见,大约50%的患者年龄在30 - 50岁之间。随着泌尿系统和体外碎石技术的发展,治疗肾结石的方法越来越多。目的:探讨影响体外冲击波碎石(ESWL)治疗肾结石成功率的因素。材料与方法:2008年4月至2008年12月间,采用StortzModulith SLX-F2碎石机对64例单发或多发透光性肾结石(::5;30mm)进行ESWL单药治疗。治疗结果在随访3个月后进行评估,治疗成功的定义是结石完全清除或存在临床不显著的残余碎片(::5;4mm)。治疗结果与患者特征(年龄、性别、体重指数)和结石特征(大小、部位、性质和放射性密度)相关。结果:随访3个月,总成功率为76%。其中19例(53.9%)患者需要重复eswlsession。eswl术后并发症8例(12.5%)。通过x2检验,只有三个因素对成功率有显著影响,分别是:结石部位、大小(结石的最大直径)、结石数量和BMI(身体质量指数)。位于花萼上部的结石成功率最高(15/15;100%),位于下花萼的最低(10/16;62.5%) (p = .005)。直径大于15毫米的结石成功率为90.2%(37 /41),而直径大于15毫米的结石成功率为52.2%(12/23)(p=.001)。单个结石的成功率也更高(46/56;82%)大于多发结石(3/8;37.5%) (p = 0.005)。结论:ESWL治疗肾结石的成功率可通过结石的大小、位置、数量和患者的BMI来预测。外科杂志(2016)Vol. 20 (2):46-50
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Prognostic Factors of Success of Extracorporeal Shock Wave Lithotripsy 46 (ESWL) in The Treatment of Renal Stones.
Background: Renal calculi are common approximately 50% of patient between the ages of 30and 50 years. The development of endourological and extracorporeal lithotripsy techniques ledto an increasing number of options for the management of renal calculi. Objective: To define factors those have a significant impact on the success rate after extracorporealshock wave lithotripsy (ESWL) for treatment of renal stones. Materials and Methods: Between April 2008 & December 2008, 64 patients with single ormultiple radiopaque renal stones (::s;30mm) were treated with ESWL monotherapy using StortzModulith SLX-F2 lithotriptor.The results of treatment were evaluated after 3 months of followupTreatment success was defined as complete clearance of the stones or presence ofclinically insignificant residual fragments (::s;4mm).The results of treatment were correlated withthe patient characteristics (age, sex, body mass index) and stone features (size, site, nature &radio density). Results: At 3-months follow-up, the overall success rate is 76%. Among them, repeated ESWLsessions are required in 19 patients (53.9%). Post-ESWL complications are recorded in 8patients (12.5%). Using the x2 test, only three factors have a significant impact on the successrate, namely: stone site, size (the largest diameter of the stone), stone number & BMI (BodyMass Index). The success rate is highest for stones located in the upper calyx (15/15; 100%)and lowest for those located in the lower calyx (10/16; 62.5%) (p=.005). Stones with a largestdiameter ot s 15mm are associated with a success rate of 90.2% (37 /41), compared to 52.2%(12/23) for those with a diameter of >15mm (p=.001). The success rate is also higher forsingle stone (46/56; 82%) than multiple stones (3/8; 37.5%) (p=0.005).Patients with lowerBMI (<24) have a better success than higher BMI (>25) (p=0.01) Conclusion: The success rate of ESWL for the treatment of renal stones can be predicted bystone size, location, number and patient BMI. Journal of Surgical Sciences (2016) Vol. 20 (2) :46-50
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