体外冲击波治疗≥2cm肾结石疗效的多因素分析  

The Factors of Treatment of Renal Stones ≥2cm with Extracorporeal Shock Wave Lithotripsy (ESWL)

作　　者：赵继明[1] 尹庭海 王建伟[1] 王玉秋[1] 徐春璐 吴海虎[1] ZHAO Ji-ming YIN Ting-hai WANG Jian-wei et al(Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China)

机构地区：[1]山东大学附属省立医院泌尿外科,山东济南250021 [2]沂源县中医院泌尿外科,山东淄博256100

出　　处：《医学与哲学（B）》2017年第7期48-51,共4页Medicine & Philosophy(B)

摘　　要：探讨应用体外冲击波碎石(ESWL)治疗≥2cm肾结石的疗效。收集2007年7月~2016年8月,在山东大学附属省立医院应用ESWL治疗肾结石≥2cm患者518例,对ESWL术后3个月的复查结果进行分析。结果显示,在治疗后3个月总净石率和有效率分别为64.3%和71.0%;多元回归分析显示肾结石的数目、形状、位置、表面积和密度与ESWL的效果均显著相关(P<0.05)。对于结石表面积低于400mm2而且KUB平片确诊为低密度的结石,有效的结石治愈率为92.0%,净石率为90.6%。对于表面积<400mm2且密度小于第12肋骨密度的肾结石,即使最大径超过2cm,ESWL是首选治疗方式。To identify subgroups of patients with renal stones ≥2cm that could be treated with extracorporeal shock wave lithotripsy （ESWL） monotherapy.A total of 518patients with renal stones ≥2cm underwent ESWL treatment in Shandong provincial hospital Affiliated to Shandong University from July 2007 to August 2016.The treatment outcomes were evaluated 3 months after ESWL.The results showed, 3 months after treatment, the overall stone-free rate and the efficacy rate was 64.3% and 71.0%, respectively.The correlations between the outcomes of ESWL and the stone features, including stone number, stone shape, stone site, stone surface area and stone density, were significant in the multivariate analysis.The stone-free rate and efficacy was 90.6% and 92.0% respectively, for stones ≤400mm2 and with lower radiodensity determined by a plain （KUB） film.For renal stones with a surface area ≤400mm2 and a radiodensity equal to or less than that of the 12th rib as determined by a KUB film, ESWL may be considered the first line of treatment, even the stones with a diameter ≥20mm.

关 键 词：肾结石 表面积 密度 X-射线 ESWL 

分 类 号：R692.4[医药卫生—泌尿科学]