年齡是否會影響體外震波碎石的治療效果？
顧芳瑜、林育瑋、吳政誠、劉明哲、張景欣、林孝友、吳建志、江漢聲、葉劭德
台北醫學大學附設醫院泌尿科
Does aging affect the efficiency of extracorporeal shock wave lithotripsy (ESWL) on ureter stone?
Fang-Yu Ku, Yu-Wei Lin, Jeng-Cheng Wu, Ming-Che Liu, Ching-Hsin Chang, Hsiao-Yu Lin, Chien-Chih Wu, Han-Sheng Chiang, Shauh-Der Yeh
Taipei Medical University Hospital, Department of Urology
Purpose:
Current evidence concerning the effect of aging on the treatment outcome of extracorporeal shock wave lithotripsy (ESWL) is still conflicting. Our study aimed to investigate whether age has an impact on treatment outcome of ESWL on ureter stone by means of retrospective chart review and analysis.
Material and Method:
Our study was a match-paired analysis comparing the 3-month stone free rate (SFR) after primary ESWL. Between March 1st, 2013 and December 31st, 2015, a total of 1204 patients received ESWL in our facility. 131 patients were above 65 years old and 72 of whom met our inclusion criteria. These patients were stratified into Group A. To compare the treatment outcome between different age group, patients in Group A were matched 1:1 to patients aged under 65 by their stone size, location and gender. These patients were sorted into Group B. We compared the treatment efficiency, co-morbidities and demographic characters between two groups.
Results:
72 patients were included in each Group with 36 male and female patients. Average stone size was 6.74 mm (95%CI 7.51-5.96) and 6.61 mm (95%CI 7.25-5.96) in Group A and B, respectively (p=0.8). There were no differences in 3 month SFR between Group A and B (63.89% vs 66.67%, p=0.73) and subgroup analysis by stone location and size also did not suggest any significance. However, re-stratification of patients regardless of age revealed stone size ≥ 10mm had an inferior SFR than that of < 10mm (37.5% vs 68.75%, p=0.01). Demographic analysis also showed baseline differences in renal function, coagulation between 2 groups and higher prevalence of diabetes mellitus, hypertension, coronary artery disease and patients receiving anticoagulant in Group A.
Conclusion:
In our study, age did not affect the 3-month SFR of ESWL regardless of stone location, but stone size was predictive of SFR. Further research concerning the mechanism affecting the efficiency of ESWL is required in the future.