体外冲击波碎石术治疗下尿路结石的并发症及影响因素分析

摘要

Objective To analyze the complications of extracorporeal shock wave lithotripsy (ESWL) for treatment of lower urinary tract stones and identify the factors contributing to the complications. Methods We retrospectively analyzed the postoperative complications of ESWL in 83 patients with lower urinary tract stones and their association with the patients' age, height, body weight, body mass index (BMI), stone features, shock wave times, and shock wave energy. Results Of the 83 cases treated with ESWL, 72.3% (60 cases) showed gross hematuria, 27.7% (23 cases) complained of pain, and 25.3% (21 cases) had both pain and gross hematuria. None of the patients reported vomiting, skin rash, flatulence, gastrointestinal bleeding or other complications. Patients with postoperative gross hematuria, pain, and both had significantly greater stone length, stone width and more shock body times than those without these complications (P＜0.01 or P<0.05). Patients with gross hematuria had significantly lower height than those without complications (P＜0.05). Conclusion The common complications of ESWL for lower urinary tract stones include hematuria and pain. The patient's height, stone length, stone width and shock times are important factors contributing to these postoperative complications.%目的 分析体外冲击波碎石术(ESWL)治疗下尿路结石的术后并发症,探讨影响术后并发症的可能因素.方法 回顾性分析83例下尿路结石患者的年龄、身高、体质量、体质量指数、结石特征、冲击次数和冲击能量与术后并发症之间的关系.结果 83例下尿路结石行ESWL治疗后,72.3％ (60例)患者出现肉眼血尿,27.7％(23例)出现疼痛,25.3％(21例)出现疼痛并肉眼血尿,所有患者均未出现术后恶心、呕吐,皮肤红斑,肠胀气及消化道出血等并发症；术后肉眼血尿组、术后疼痛组、术后疼痛并肉眼血尿组结石长度、结石宽度、冲击次数分别高于无并发症组,两组间有明显的统计学差异(P＜0.01或P＜0.05),术后肉眼血尿组患者身高明显低于无并发症组,有明显的统计学差异(P＜0.05).结论 ESWL治疗下尿路结石术后常见并发症为血尿及疼痛,患者身高、结石长度、结石宽度及冲击次数是影响术后并发症发生的重要因素.