| Summary: | 碩士 === 亞洲大學 === 健康管理研究所 === 95 === Objective: Since the implementation of National Health Insurance, the method for payment is fee-for-service. The highest payment unit in medical equipment usage is per outpatient treatment in ESWL. This study is to understand the stone-free rate after ESWL and analysis the factors that affect the recurrence rate.Materials and Methods: Between Jul. 2000 to Jun 2001, total 706 patients underwent ESWL in Cheng-Ching general hospital. We retrospectively reviewed the stone-free rate and recurrence rate after ESWL. Furthermore,we investigated the factors that contributed the stone-free rate and recurrence rate with Logistic regression analysis.
Results: There are 506 males and 200 females in this study. Mean age was 47.23 y/o (range from 16 to 86 y/o). Totally 763 renal units were enrolled. In these 763 renal units, 439 were stone-free after ESWL and the other 324 were not. The stone-free rate is 57.53%. Stone recurred in 123 of 439 renal units (28%). The stone size, number and location are significant factors that affect the stone-free rate. The stone free rate of upper ureteral and upper renal calyceal stones are higher than lower calyceal stone. Patients with an early onset of stone formation had the higher recurrence rate. In addition, lower calyceal stone is easier recurred than upper ureteral stone.
Conclusion: ESWL is a less invasive and effective method for urolithiasis.However, lower stone-free rate and higher recurrence rate resulted in higher utilization of ESWL. Complete image study and a proper management will increase the stone free rate. In additional to age and stone location, education on changing in diet habit and life style is important.
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