原文：Four decades with Extracorporeal Shock Wave Lithotripsy Lessons learnt
Hans-Göran Tiselius (Department of Urology, Karolinska Institute, Sweden)
Christian G Chaussy (University of Regensburg, Bavaria, Germany)
Extracorporeal shock wave lithotripsy: four decades with lessons learnt
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摘要: 1980年，体外冲击波碎石术(extracorporeal shock wave lithotripsy，SWL)的出现无疑给尿石症患者的治疗带来了革命性的变化，到目前为止已经治疗了数百万名结石患者。然而，SWL的治疗结果受到操作水平的影响，技术的准确使用和细节的注意对于获得满意的治疗效果至关重要，特别是对于输尿管结石。SWL不仅创伤小、经济，而且可以在没有全身或局部麻醉的情况下完成，它还可以在没有手术室的门诊环境下进行。此外，这种不需要麻醉的结石治疗方法，在COVID-19时期使医务工作者避免了与冠状病毒的气溶胶接触。另外一些不需要麻醉的微创辅助治疗可以处理一些SWL治疗不成功的患者。在这篇综述中，我们总结了在过去40年中使用SWL而遇到的各种的临床问题，在现有的知识体系下，提供实用且可操作的信息，为临床工作者在平衡SWL治疗效果与患者安全方面提供有力的参考和依据。Abstract: The emergence of extracorporeal shock wave lithotripsy(SWL) in 1980 undoubtedly brought revolutionary changes to the treatment of urolithiasis patients, having treated millions of stone patients to date. However, the treatment outcomes of SWL are influenced by the level of operation, and the accurate use of technology and attention to detail are crucial for achieving satisfactory treatment results, especially for ureteral stones. SWL is not only minimally invasive and cost-effective but can also be performed without general or local anesthesia, and it can even be conducted in outpatient settings without surgical facilities. Additionally, this anesthesia-free stone treatment method has enabled healthcare workers to avoid exposure to aerosols of the coronavirus during the COVID-19 pandemic. Furthermore, some minimally invasive adjunctive therapies that do not require anesthesia can treat some patients who have had unsuccessful SWL treatments. We have summarized various clinical issues encountered in the past forty years of using SWL and completed this review, summarizing practical and feasible information within the existing knowledge framework to provide robust reference and guidance for clinicians on balancing SWL treatment effectiveness and patient safety.
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Key words:
- extracorporeal shock wave /
- urolithiasis /
- experience /
- lessons learned
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