肾感染石的单一ESWL治疗

观察单一体外冲击波碎石术（ESWL）治疗肾感染石的疗效，探讨碎石过程中的定位技术和冲击方法，采用B超或X线定位碎石机治疗128例肾感染石患，其中部分性鹿角石116例，完全性鹿角石12例；结石为单发101例，多发27例，共178枚，结石直径1．4－1．7cm，平衡2．2cm，碎石前，在33例体积较大的患中，28例放置双“J”管，5例放置Dormia支架，单次治愈71例（55．47％），2次30例（23．44％），3次13例（10．16％），4次5例（3．91％），5次（91％），失败（3．13％），要后因尿路感染而发热14例（10．94％），其中1例被迫行肾切主，其余均用抗生素治愈，17例（13．28％）并发5cm以上的石街，经保守治疗或重复碎石后痊愈，未出现其他严重并发症，认为在肾感染石碎石过程中，B超定位效果优于X线；单一ESWL治疗肾感染石是一种安全、有效的方法。

Extracorporeal Shock Wave Lithotripsy Monotherapy for Renal Infection Stones

A total of 128 patients with renal infection stones underwent ESWL monotherapy with lithotriptors using ultrasound or fluoroscopic localization system so we could observe the effect of extracorporeal shock wave lithotripsy (ESWL) monotherapy for treatment for renal infection stones. Of these patients 116 had partial and 12 had complete staghorn calculi. There were altogether 178 calculi whose diameters ranged from 1.4 to 4.7?cm(mean 2.2?cm). Preoperatively, Double-J ureteral catheters were applied to 28 patients with larger stone burden and Dormia stents to 5 similar ones. At the followup 71 cases ( 55.47%) were cured in one session, 30 ( 23.44%) in two sessions, 13 ( 10.16%) in three sessions, 5 in four sessions and 5 in five sessions. Four cases (3.13%) failed in the treatment. Fourteen patients (10.94%) were complicated by fever due to urinary tract infection after ESWL. One of them had to undergo nephrectomy and the remainders were cured with antibiotics. Steinstrasse occurred in 17 patients (13.28%), which were soon cured by conservative procedures or repeating ESWL. No other serious postoperative complications were found. Ultrasound was superior to fluoroscopy in stone localization during lithotripsy; ESWL was considered to be a safe and effective treatment for renal infection stones.