影響體外震波碎石成功率的因子—恩主公醫院的經驗
陳柏誠2、劉育廷1、陳建志2、陳建華2、柯智群2、王炯珵1,2
中原大學生物醫學工程學系研究所1、恩主公醫院泌尿科2
Factors influencing the outcome of extracorporeal shock wave lithotripsy for renal stones and ureteral stones: one hospital experience
Po-Cheng Chen2,Yu Ting Liu1,Chien Chih Chen2,Chien Hua Chen2,Chih-Chun Ke2,Chung Cheng Wang1,2
Department of Biomedical Engineering,Chung Yuan Christian University1
Urology Department,En Chu Kong Hospital2
Purpose:
Extracorporeal shock wave lithotripsy (ESWL) is a widespread method to manage both renal stones and ureteral stones. We investigated the patients who received ESWL in our hospital to find out which factors influenced the outcome.
Materials and Methods:
From January, 2013 to December, 2013, we retrospectively reviewed the chart of 641 patients who underwent ESWL in our hospital. These patients were divided to the renal stone group and the ureteral stone group. We analyzed the patient character (such as age, sex, height, weight, BMI, and serum creatinine level) and the stone character (stone size, position, the hydronephrosis status detected by renal ultrasound, the pre-operative ureter stent placement) Success for stone-free was defined as <0.4 mm in follow up KUB plain film.
Results:
The stone-free rate was 54.8% in all patients. The stone-free rates were 46.7% and 67.8% in renal stone group and ureteral stone group. In univariate logistic regression for all patients, we could find that age, BMI, stone size, pre-operative ureter stent insertion and ureter or renal stone were statistically significant to stone-free rate. In multivariate logistic regression for all patients, only stone size, BMI and ureter or renal stone got statistically significant. In univariate analysis of the renal stone group, we can find that age BMI and stone size showed statistically significant to influence the success rate. In the multivariate logistic regression of the renal stone group, BMI and stone size are the independent factors which affect the success rate. In univariate analysis of the ureteral stone group, only the stone size showed statistically significant. In the multivariate logistic regression of the stone length and stone width of the ureteral stone, only stone length is the independent factor.
Conclusion:
Stone size is the most important factors influencing the outcome of ESWL both in renal stone and ureteral stone. In the ureteral stone group, the stone length is the more important factor than stone width.