泌尿器科レジデントがおこなった開放性腎生検の検討

Abstract

患者の内訳は小児科14例, 腎臓内科16例, 泌尿器科1例で, 男19例, 女12例である.術者は卒後1年目のジュニアレジデントより卒後6年目のチーフレジデントまでさまざまである.本手術の指導者は講師以上であった.皮膚切開は小児科患者は3～7 cm, 5cmが7例と多く, 腎泌尿器患者では5～115 cm, 10 cmが多かった.手術時間は小児科患者では平均89.2分, 腎泌尿器科患者のそれは122.2分であった.術中出血量最小の2例を除いた小児科12例の出血量は28.2 mlで, 腎泌尿患者では235.1 mlであった.術中輸血に行った.創部ドレインは腎泌尿器患者4例に留置した.重篤な合併症を1例に認めたが, 生命に影響はなかった.以上より若干の問題点はあるが, 腎泌尿器科レジデントが術者として初めて行った開放生腎生検の結果としてはほゞ納得がいくと考えた

The results of the operative aspects of open renal biopsy performed by urologic residents at our University Hospital during the 18 months from July 1982 to December 1983 were analyzed. Open renal biopsy was performed by 1st to 6th year residents for various renal diseases on 19 male and 12 female patients, i.e., 14 patients from Pediatric Department, 16 patients from Nephrologic Department and 1 patient from Urologic Department. All except for 3 operations were done under the guidance of urologic staff. The length of incisional line ranged from 3 to 7 cm (average 5.1 cm) in pediatric patients, and that of nephrologic and urologic patients ranged from 5 to 15 cm (average 8.7 cm). The average operation time was 89.2 minutes for pediatric patients, although it was 81.1 minutes when 1 patient who had concurrently operated on inguinal herniorrhaphy in addition to open renal biopsy was excluded from the analysis. The average operation time was 122.2 minutes for nephrologic and urologic patients, although it was 112.8 minutes when 1 patient who had lost a large amount of blood was excluded. The average blood loss was 28.2 ml for pediatric patients when 2 patients whose blood loss was recorded as "small quantity" was excluded, but it was 24.5 ml when 1 patient who was concurrently operated on for inguinal herniorrhaphy in addition to open renal biopsy was excluded. The average blood loss during operation was 235.1 ml in nephrologic and urologic patients, but it was 149.95 ml when 1 patient who had lost a great deal of blood (1, 598 ml) was excluded.(ABSTRACT TRUNCATED AT 250 WORDS)