بـررسی موفـقیت سنگ شـکن بـرون اندامی (ESWL) در تعدادی از بیماران مراجعه کننده به مراکز سنگ شکنی مشهد در سال 85 و 86
Subject Areas : علوم پزشکیMasud Isapour 1 , Rahim Taghavi 2 , Zahra Ruhani 3
1 -
2 -
3 -
Keywords: shock, lithotripsy, stone, extra corporeal,
Abstract :
Aim: Efficacy of extra corporal shock wave lithotripsy (ESWL) in patients with renal stones referred to lithotripsy centers in Mashhad for one and half year. Methods and Material: In a cross sectional study, by a simple randomized sampling, 71 patients suffering renal stone entered to this study. First according to the edited questionnairies, site and size of stones were considered. Then after extra corporeal shock ware lithotripsy, rate of shock waves were recorded. And patients were followed in two stages (two and four weeks after extra corporeal shock wave lithotripsy) finally successness of this procedure and quality of stones were considered. Results: 1- the rate of successness of extra corporeal shockwave lithotripsy in our study was 74/6%. 2- From 56 completely delivered stones , 78/6% were Mixed, 10/7% were Uric Acid, 7/1% were Calcium Oxalate, 3/6% were Calcium Phosphate. It is remarkable that all of the Uric Acid stones, Calcium Oxalate Stones and Calcium Phosphate Stones in our samples were completely delivered. 3- In our study, 65% of caliceal stones, 78% of pelvic stones and 100% of proximal ureteral stone were delivered which this difference is significant. (P<0/05) 4- 89% of stone smaller than 10 mm and 51.7% of stones bigger than 10 mm were completely delivered which this difference is significant. (P=0/000287) 5- 99% of stones were fragmented by using 2500-3000 shocks. Conclusion: Extra corporeal shock wave lithotripsy is more successful in treatment of stone smaller than 10mm. the most stone free rate belongs to proximal ureteral stones, more than pelvic stones more than caliceal stones. We found that 2500-3000 shocks is adequate for fragmentation of stone with any size, location and quality.
1- Marshall L. Stoller. Urinary Stone Disease. In: Tanagho, E. A, MC Aninch J.W, editors. Smith's General urology. 17th ed. USA: MC Graw – Hill; 2008. P.246-275.
2- James E. Lingeman, Brian R. Matlaga , Andrew P. Evan. Surgical Management of upper urinary Tract Calculi. In: Walsh P.C, editor. Campbell's urology. Volume 4. 9th ed. USA: SAUNDERS EISEVIER; 2007. P.1431-1480.
3- Drake R.L, Vogl W, Mitchell A. W. M, Gray's Anatomy for students. 39th ed. Spain: Elseveir Churchill livingstone; 2005.
4- Soufi Majid pour H. Efficasy and complication ESWL and considering the related factors, in Tohid Hospital in Sanandaj from 1994-1999. Medical Journal of Medical University of Kordestan 2001; 5(19): 5-9.
5- Pejman M, Tadayon A. Result of ESWL in urinary system calculi. Iran Urology Journal 1995; 2(5, 6): 75-80.
6- Zoulphaghari A, Hasanzadeh K. Stone free rate of ureteral stones after ESWL. Medical Journal of Medical University of tabriz.
7- Mombeyni H, Ababaf M. Results of ESWL in SinaHospital of Ahvaz. Medical Journal of MedicalUniversity of Ahvaz 1998; 8(25): 49-53,
8- Demirkesen O, Onal B, Tansu N. Efficasy of ESWL for isolated lower caliceal stones in children compared with stones in other renal locations. EUA 2005: 48.
9- Brinkmamm, O. Griehl, A. Bulle, MD. ESWL in children Efficasy, complication and long term follow up. Medline Abstract 2001; (39):5.
10- Seitz, C. Remzi, md. Delay in ESWL treatment after a first colic episode correlates with decelerated ureteral stone clearance. EUA 2005:48.
_||_