Efficacy of ultrasound monitoring during extracorporeal shock wave lithotripsy: A multi‐institutional propensity score‐matched study
Efficacy of ultrasound monitoring during extracorporeal shock wave lithotripsy: A multi‐institutional propensity score‐matched study
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体外冲击波碎石术中超声监测的功效：多机构倾向评分匹配研究
DOI：
10.1111/iju.14984
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发表时间：
2022
影响因子：
2.6
通讯作者：
Yasui Takahiro
中科院分区：
文献类型：
--
作者：
Isogai Masahiko;Hamamoto Shuzo;Kawase Kengo;Okada Tomoki;Hattori Tatsuya;Chaya Ryosuke;Hamakawa Takashi;Sugino Teruaki;Taguchi Kazumi;Umemoto Yukihiro;Okada Atsushi;Yasui Takahiro
目的评价超声监测在冲击波碎石术治疗肾结石和输尿管上段结石中的作用。方法回顾分析2012年1月至2021年12月间首次接受冲击波碎石治疗的肾结石和输尿管上段结石患者。根据冲击波碎石中结石的定位和监测方法，将患者分为X线组(n= )294例和超声+X线组(n= )241例。由于患者背景的不同，进行了1：1倾向得分匹配。结果在最终的1：1匹配队列中，192例肾结石和162例输尿管上段结石病例被分析。对于肾结石患者，超声加X线组结石排净率为66.7%，明显高于X线组的47.9%(P= 0.013)。在多因素分析中，结石面积较大(优势比2.37)、肾盏结石较低(优势比3.37)和单纯X线监测(优势比0.49)是冲击波碎石失败的独立相关因素。对于输尿管上段结石，超声+X线组与X线组结石排净率分别为71.6%和58.0%，差异无统计学意义(P= 0.100)。在多因素分析中，CT衰减大(优势比2.31)和结石面积大(优势比2.18)是冲击波碎石术后结石残留率的独立相关因素。结论超声监测对肾结石患者有较高的排净率，但对输尿管上段结石患者无明显影响。
ObjectivesTo evaluate the efficacy of ultrasound‐assisted monitoring during shock wave lithotripsy for kidney and proximal ureteral calculi.MethodsWe retrospectively reviewed 535 patients who initially underwent shock wave lithotripsy for renal or proximal ureteral calculi between January 2012 and December 2021. The patients were divided into the X‐ray group (n= 294) and ultrasound plus X‐ray group (n= 241) based on the methods of targeting and monitoring calculi during shock wave lithotripsy. Because of differences in patient backgrounds, 1:1 propensity score‐based matching was performed. The primary endpoint was the stone‐free rate.ResultsIn the final 1:1 matched cohort, 192 kidney stone cases and 162 proximal ureteral stone cases were analyzed. For patients with kidney calculi, the stone‐free rate of the ultrasound plus X‐ray group was significantly higher than that of the X‐ray group (66.7% vs. 47.9%;P= 0.013). In the multivariate analysis, a large stone area (odds ratio 2.37), lower caliceal stones (odds ratio 3.37), and X‐ray monitoring alone (odds ratio 0.49) were independently associated with shock wave lithotripsy failure. For patients with proximal ureteral stones, there was no significant difference in the stone‐free rate between the ultrasound plus X‐ray group and X‐ray group (71.6% and 58.0%, respectively;P= 0.100). During the multivariate analysis, high computed tomography attenuation (odds ratio 2.31) and large stone area (odds ratio 2.18) were independent factors associated with residual stones after shock wave lithotripsy.ConclusionsUltrasound‐assisted monitoring may contribute to a higher stone‐free rate for patients with kidney calculi, but not for those with proximal ureteral calculi.
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影响因子：
2
作者：
Yang, Seung Woo;Hyon, Yun Kyong;Song, Ki Hak
通讯作者：
Song, Ki Hak
冲击波碎石术、经皮肾镜取石术和输尿管软镜检查后下极肾盏结石清除：放射学空间解剖学的影响。
影响因子：
2.7
作者：
A. Elbahnasy;R. Clayman;A. Shalhav;D. Hoenig;P. Chandhoke;J. Lingeman;J. Denstedt;R. Kahn;D. Assimos;S. Nakada
通讯作者：
S. Nakada
冲击波碎石治疗上、中、下盏肾结石的结果比较。
影响因子：
2.7
作者：
B. Turna;F. Ekren;O. Nazlı;K. Akbay;B. Altay;C. Ozyurt;N. Çikili
通讯作者：
N. Çikili
影响因子：
2.6
作者：
Yamashita, Shimpei;Kohjimoto, Yasuo;Hara, Isao
通讯作者：
Hara, Isao
影响因子：
--
作者：
Van Besien J;Uvin P;Hermie I;Tailly T;Merckx L
通讯作者：
Merckx L