超音波導引體外震波碎石以減少輻射暴露
林嘉緯1、江怡德1、陳紹民2、崔克宏1
1衛生福利部雙和醫院；2臺北市立聯合醫院和平院區
The Ultrasound-guided Extracorporeal Shock Wave Lithotripsy with Minimal X-ray Exposure to Treat the Urolithiasis in Taiwan
Chia-Wei Lin1, Yi-Te Chiang1, Shao-Ming Chen2, Ke-Hung Tsui1
1Department of Urology, Shuang Ho Hospital, School of Medicine, College of Medical, Taipei Medical University, Taipei, Taiwan
2Department of Urology, Heping Campus, Taipei City Hospital, Taipei, Taiwan
Purpose:
We looked into the extracorporeal shock wave lithotripsy guided by the ultrasound to break the stone in genital urinary tract. Accurate focusing and minimal X-ray exposure are our goals to stand on the patients’ interest.
Materials and Methods:
A retrospective review was performed for prospectively collected data of patients with urolithiasis underwent ESWL treatment. The LiteMed LM-9200lithotripter utilized ultrasonography and fluoroscopy for dual focusing stone localization and tracking.
Results:
The average stone size is 1.0cm (range: 0.4cm-2.5cm). The average energy of the shock wave (kv) is 18 (range: 16.5-20.5). Of three hundred thirty-three patients receiving auto-aimed procedure, 133 patients suffered gross hematuria. Seventy-three patients had gross hematuria in 112 patients who received auto periodical procedure. The average durations of the x-ray exposure in auto periodical are 120 seconds, and 50 seconds in auto-aimed respectively
Conclusion:
Utilizing the minimal X-ray exposure, the ultrasound-guided extracorporeal shock wave lithotripsy is a statistically significant useful tool to treat the upper tract of urolithiasis (p<0.001). It seems that patients in auto-aimed procedure suffered non-hematuria statistically significant, compared with those in auto-periodical procedure (p<0.001).