摘要
目的探讨体外冲击波碎石治疗经皮肾镜术后残石的时机及对治疗安全性、结石清除率的影响因素。方法回顾性分析2007年6月至2015年5月间行PCNL术后发生残石行体外冲击波碎石(ESWL)治疗的216例患者病例资料,通过CT影像片确定残石CT值(HU)、计算皮肤与残石间距离(SSD)、残石直径大小,同时计算患者体质量指数(BMI)及统计结石成分等。按术后2周、4周行ESWL将病例分成A(n=96)、B(n=120)两组。结果两组病例均无出现严重并发症。两组患者在病例资料差异比较无统计学意义情况下,B组与A组在结石清除率及疼痛、肉眼血尿、肾周血肿发生率的差异具有统计学意义。结论 PCNL术后行ESWL治疗残石是一种有效的方式,选择PCNL术后的第4周行ESWL的结石清除率优于第2周,且并发症少。对于BMI>28、SSD>10 cm、下盏残石、残石CT值>1000 Hu在治疗上再次出现残石率高。
Objective To explore the right time ofextracorporeal shock wave lithotripsy （ESWL） for the residual stone after percutaneous nephrolithotomy （PCNL） and analyze the factors related to the safety and the stone free rate. Methods Two hundred and sixteen patients needed ESWL to deal with residual stones after PCNL between June 2007 to May 2015. CT value of residual stone obtained by CT image （hounsfield units, HU）, the distance between the skin and the residual stone （skin-to-stone distance, SSD）, the diameter of residual stone, the mass index BMI body （BMI） and the composition of the stones were analyzed. The patients were divided into group A （n=96） and B （n=120） according to patients undertook ESWL in 2 weeks and 4 weeks after surgery respectively. Results No severe complications occurred in the two groups. No significant differences between the two groups in clinical data. The stone free rate and pain, hematuria, perirenal hematoma in group B were better than that in group Conclusion ESWL for postoperative residual stone of PCNL is effective. The group which 4 weeks after PCNL underwent ESWL is better than 2 weeks group on stone free rate, and fewer complications. For the obesity patients （BMI〉28, SSD〉10 cm）, lower calyx residual stone, residual stone CT values〉1000 Hu, higher stone recurrence can be observed after treatment.
出处
《中华腔镜泌尿外科杂志（电子版）》
2016年第4期17-19,共3页
Chinese Journal of Endourology(Electronic Edition)
作者简介
通讯作者：李淦洪，Email：excellent338@163.com
