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1983年至1986年,作者用经皮超声碎石术治疗了15例(17个肾脏)尿路胱氨酸结石病人。术后3人失去随访。获得随访的12例病人(6男5女,年龄15—41岁)术后均接受高液体量摄入、单用碱化尿液或结合应用protohated thiols或二硫化物(disulfide compounds)等内科治疗。随访10—31月。结果术后12例病人的13个肾脏(1例双肾鹿角形结石)中,7例有碎石残石残留,6例结石排尽。内科治疗期间,7例肾有新结石形成,5例肾无变化,1例肾残留碎石被溶解。有碎石残留者的再次手术率为43％(3/7),结石排尽者再次手术率为17％(1/6)。作者认为:尿路胱氨酸结石病人,伴有有症状的尿路梗阻(无论有、无感染)或伴有不适于溶解疗法的钙石、鸟粪石,应优先考虑经皮超声碎石术。该术的再位疗效应是术后结石排尽(结石排尽
From 1983 to 1986, the authors treated 15 patients (17 kidneys) of urinary cystine stones with percutaneous ultrasonography. Three patients lost follow-up. Twelve patients (6 males and 5 females, aged 15-41 years) who were followed up received a high dose of fluid after surgery, with alkalized urine alone or in combination with other medical treatments such as protohated thiols or disulfide compounds . Follow-up 10-31 months. Results Of the 13 kidneys in 12 patients (1 double nephrodder), residual stones were found in 7 cases and residual stones were found in 6 cases. During the medical treatment, 7 cases of new kidney stones formed, 5 cases of kidney no change, 1 case of kidney residual gravel was dissolved. The rate of reoperation was 43% (3/7) in those with residual gravel, and 17% (1/6) in reoperation. The authors suggest that percutaneous transluminal lithotripsy should be given priority in patients with urinary cystine stones, with symptomatic urinary tract obstruction (with or without infection) or with calcium and struvite unsuitable for dissolution therapy . The effect of re-treatment of the operation of the stone is drained after the operation (stones drain