【摘要】 目的　探讨影响体外冲击波碎石术(ESWL)疗效的因素。　方法　回顾ESWL治疗尿路结石患者234例的临床资料。分析患者性别、年龄、病程、结石大小、位置、X线形态及合并肾积水情况等因素与治疗成功率的关系。ESWL术后3个月接受KUB、IVU和B超检查,剩余结石<2mm为碎石成功, >2mm为治疗不成功。　结果　234例碎石成功率78. 6% (184 /234)。男性组和女性组治疗成功率分别为80. 3% (122 /152)和75. 6% (62 /82),P>0. 05。治疗不成功组与成功组病程分别为(1262. 6±1742. 1)d、(722. 9±1364. 6)d,P>0. 05;结石直径分别为(1. 1±0. 6)cm、(1. 0±0. 4)cm,P>0. 05;年龄分别为(58. 8±13. 6)岁、(42. 8±12. 2)岁,P<0. 05。肾盂结石(22. 7%, 10 /44)与肾盏结石(40. 0%, 8 /20),肾盂结石与输尿管结石( 18. 8%, 32 /170 ),输尿管上段结石( 15. 8%, 18 /114)与下段结石(25. 0%, 14 /56)间不成功率比较,差异无统计学意义(P>0. 05)。均匀高密度结石(20. 0%, 6 /30)与杂色结石(21. 6%, 44 /204)不成功率两组比较差异无统计学意义(P>0. 05)。结石直径0. 3~1. 0cm者(1. 9%, 2 /108), 1. 0 ~2. 0cm者(29. 8%, 28 /94), >2. 0cm者(62. 5%, 20 /32)不成功率3组两两比较P<0. 05。结石大小与治疗剂量呈正相关(r=0.28,P=0. 006)。更多还原

【Abstract】 ObjectiveTo evaluate the factors which influence the efficacy of extracorporeal shock wave lithotripsy (ESWL).MethodsThe data of 234 patients with urinary calculi who underwent ESWL were reviewed.The correlation of age,gender,disease course,stone size,location,X-ray findings and hydronephrosis with curative success rate was analyzed.Three months after ESWL,the patients underwent KUB,IVU and B-US examinations.If the residual stones were <2 mm in diameter,ESWL was considered successful;by contrast,ESWL was considered unsuccessful with the residual stones >2 mm in diameter.ResultsThe overall success rate of fragmentation was 78.6%(184/234),and for male and female groups the success rates were 80.3% (122/152) and 75.6% (62/82),respectively ( P >0.05).The differences of gender,disease course [(1262.6±1742.1) d vs (722.9±1364.6) d], stone diameter [(1.1±0.6) cm vs ( 1.0± 0.4) cm] between failure group and success group were not statistically significant ( P >0.05). The difference of age [(58.8±13.6) years vs (42.8±12.2) years] between failure group and success group were statistically significant ( P <0.05). The difference of failure rates between pelvic stones (22.7%,10/44) and caliceal stones (40.0%,8/20),pelvic stones and ureteral stones (18.8%,32/170),upper ureteral stones (15.8%,18/114) and lower ureteral stones (25.0%, 14/56);high density stones (20.0%,6/30) and mixed density stones (21.6%,44/204) were not statistically significant ( P >0.05).The differences of failure rate between mild-moderate hydronephrosis group (18.5%,40/216) and severe hydronephrosis group (55.6%,10/18); 3 groups of different stone size [0.3-1.0 cm (1.9%, 2/108), 1.0-2.0 cm ( 29.8 %,28/94),>2.0 cm (62.5%,20/32) in diameter] were statistically significant ( P <0.05).Stone size was positive correlated with therapeutic dosage ( r=0.28,P =0.006).ConclusionsAge,stone size and concomitant hydronephrosis may be important factors influencing the efficacy of ESWL.更多还原