Prediction of stone-free rates after extracorporeal shockwave lithotripsy for treatment of high-density ureteral stones

doi:10.3877/cma.j.issn.1674-0785.2022.04.004

Abstract

Abstract:

Objective

To identify the influencing factors of extracorporeal shockwave lithotripsy (ESWL) in the treatment of high-density ureteral calculi (CT value > 1000 HU).

Methods

Clinical data of single ureteral calculi with a CT value > 1000 HU diagnosed at Peking University Shougang Hospital from June 2015 to June 2020 were retrospectively collected, and the efficacy and influencing factors of the first external lithotriptomy were analyzed.

Results

Sixty-five patients were included in the study. The average stone size was (10.63±3.24) mm, the average stone density (CT value) was 1202±126 HU, and the success rate of lithotripsis was 63.1%. Stone size was an independent factor affecting the therapeutic effect of ESWL (odds ratio=1.586, 95% confidence interval: 1.162~2.166, P=0.004). ROC analysis showed that the critical value of stone size for predicting ESWL efficacy was 1 cm.

Conclusion

For ureteral calculi with a CT value＞1000 HU, stone size is an independent predictor of ESWL efficacy, and the success rate of ESWL for calculi ≤ 1 cm was 84.8%.

Key words: Ureteral calculi, Extracorporeal shockwave lithotripsy, High-density stones, Efficacy, Influencing factors

Bing Yang, Dongliang Pan, Lianchao Jin, Zhe Zhou, Pengfei Gao, Ze Zhou, Zhihong Zhang, Ningchen Li. Prediction of stone-free rates after extracorporeal shockwave lithotripsy for treatment of high-density ureteral stones[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(04): 308-311.

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URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2022.04.004

https://zhlcyszz.cma-cmc.com.cn/EN/Y2022/V16/I04/308

Figures/Tables 4

项目	n=65
年龄（岁， $x ¯$ ±s）	49.43±11.47
性别［例（%）］
女	30（46.2）
男	35（53.8）
分侧［例（%）］
左侧	38（58.5）
右侧	27（41.5）
位置［例（%）］
上段	40（61.5）
中下段	25（39.5）
大小（mm， $x ¯$ ±s）	10.63±3.24
密度（HU， $x ¯$ ±s）	1202±126
≤1200［例（%）］	36（55.4）
＞1200［例（%）］	29（44.6）
震波次数（次， $x ¯$ ±s）	1977±316
＜2000［例（%）］	31（47.7）
≥2000［例（%）］	34（52.3）
ESWL中结石碎裂情况［例（%）］
碎裂	45（69.2）
未碎裂	20（30.8）
碎石成功率［例（%）］
成功	41（63.1）
未成功	24（36.9）

项目	n=65
年龄（岁， $x ¯$ ±s）	49.43±11.47
性别［例（%）］
女	30（46.2）
男	35（53.8）
分侧［例（%）］
左侧	38（58.5）
右侧	27（41.5）
位置［例（%）］
上段	40（61.5）
中下段	25（39.5）
大小（mm， $x ¯$ ±s）	10.63±3.24
密度（HU， $x ¯$ ±s）	1202±126
≤1200［例（%）］	36（55.4）
＞1200［例（%）］	29（44.6）
震波次数（次， $x ¯$ ±s）	1977±316
＜2000［例（%）］	31（47.7）
≥2000［例（%）］	34（52.3）
ESWL中结石碎裂情况［例（%）］
碎裂	45（69.2）
未碎裂	20（30.8）
碎石成功率［例（%）］
成功	41（63.1）
未成功	24（36.9）

项目	结石碎裂情况				碎石疗效
项目	碎裂	未碎裂	χ²值	P值	成功	未成功	χ²值	P值
性别			0.339	0.560			2.898	0.089
女	18（62.1）	11（37.9）			15（51.7）	14（48.3）
男	27（75.0）	9（25.0）			26（72.2）	10（27.8）
分侧			0.143	0.706			0.256	0.613
左侧	26（68.4）	12（31.6）			23（60.5）	15（39.5）
右侧	19（70.3）	8（29.6）			18（66.7）	9（33.3）
位置			0.874	0.350			0.165	0.684
上段	27（67.5）	13（32.5）			26（65.0）	14（35.0）
中下段	18（72.0）	7（28.0）			15（60.0）	10（40.0）
密度（HU）			4.858	0.028			4.925	0.026
1000~1200	28（77.8）	8（22.2）			27（75.0）	9（25.0）
＞1200	17（58.6）	12（41.4）			14（48.3）	15（51.7）
震波次数			0.618	0.432			0.053	0.818
＜2000	19（61.3）	12（38.7）			20（64.5）	11（35.5）
≥2000	26（76.5）	8（23.5）			21（61.8）	13（38.2）
结石大小（cm）			10.943	0.001			13.642	＜0.001
≤1 cm	29（87.9）	4（12.1）			28（84.8）	5（15.2）
＞1 cm	16（50.0）	16（50.0）			13（40.6）	19（59.4）

变量	结石碎裂情况		碎石疗效
变量	P值	OR（95%CI）	P值	OR（95%CI）
年龄	0.363	0.974（0.919~1.031）	0.614	1.015（0.957~1.076）
性别	0.271	2.012（0.579~6.994）	0.066	3.192（0.926~11.004）
分侧	0.355	1.819（0.512~6.460）	0.524	0.655（0.178~2.412）
位置	0.113	0.333（0.085~1.299）	0.735	1.253（0.339~4.632）
大小	0.055	1.324（0.994~1.764）	0.004	1.586（1.162~2.166）
密度	0.944	1.066（0.183~6.203）	0.467	0.511（0.083~3.124）
震波次数	0.119	0.365（0.103~1.296）	0.967	0.974（0.280~3.391）

References 9

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