The Factors Influence ESWL's Efficiency

Back groud: In 1980, Chaussy first treated urinary stone with extracorporeal shock wave lithotripsy(ESWL) 0 From then on, ESWL has been the primary therapy method for urinary stone 0 In the recent reports , ESWL 's success rates aren't higher than the initial ones. So we reassess the factors which influence ESWL's success rate, in order to choose appropriate cases to improve ESWL's success rateoExtracorporeal shock wave is similar to sound wave. Its transmit character is associated with medium physi-chemical character o It has been demonstrated that cystine> calcium oxate monohydrate> brushite stone are resistant to ESWL and most naturalhuman urinary stones are mixture compounded . The relationship between the interaction of human stones component and ESWL's efficiancy is still uncertain 0 Our study mainly discussed the relationship between the interaction of human stones component and ESWL's efficiancy oThe main objects of this study are (l)Record complete clinical date of ESWL's cases; (2)Obtain stone samples that associated with ESWL; (3)Analyze stone component by infrared spectroscopy; (4)Detect factors that influence ESWL's success rate ?Materials and methods117 cases of urinary stone with complete clinical dates who were treated with ESWL from May 2000 to December 2001 were involved in our study ?Clinical dates included gender, age, in charge number, course of diseases, X ray form, stone location, stone length, degree of hydronephrosis, treatment energy, shock times, therapy times, stone discharge time, success time, pre-operation and post-operation blood pressure , pre-operation and post-operation serum Bun and Cr0 We analyzed stone component by infrared spectroscopy adopt KBr (potassium bromide) planish method ?Alldates were analyzed by SPSS 10.0 Statistic soft-shell ?Result1 Success rates have no significant difference between male and female groups.2 Mean age of the success group is younger than the failed .3 Course of disease has no significant difference between the success group and the failed ?4 Stone location doesn't contribute to ESWL's success rate05 Mean treatment dosage has no significant difference between the success group and the failed 06 Stone length has positive relative rate with treatment dosage in the succeeded group. It has significant statistical meaning. The mean treatment dosage is 4904 per centimeter ?7 Most urinary stones are mixture compounded. The main components are calium oxate and apatite 08 Proportion of calium oxate and apatite doesn't influence ESWL's success rate0 ESWL's success rate has no significant difference between calium oxate and apatite mixture to pure calium oxate 09 Stone accompanied with severe hydronephrosis has less successrate than that without severe hydronephrosis. It has significant statistical meaningConclusionOld age and severe hydronephrosis are obstacles to ESWL's success rate; stone location, course of disease and gender don't contribute to ESWL's success rate; large stone need high treatment dosage Our lithotripor has a mean treatment dosage to unit stone length There was no significant difference of ESWL's success rate between calium oxate and apatite stone As most stones are oxate and apatite stones, analyzing stone composition before initial treatment has little clinical meaning...