単一尿管結石患者における術前99mTc-DTPAレノグラフィ所見ならびに利尿レノグラフィ所見の有用性 外来ESWLでの完全排石予測因子としての検討

Abstract

外来ESWL治療前に99mTc-DTPAレノグラフィならびに利尿レノグラフィを施行した尿管結石79症例に関して検討を加えた.単一尿管結石患者でレノグラムパターンが正常型, 或いは閉塞型であっても利尿レノグラムで反応なし, の型であれば外来ESWLで治療できる(単独治療で完全排石が期待できる)ことが示された

We analyzed the 99mTc-DTPA renogram with and without diuresis to predict the possibility of stone discharge on the outpatient basis by renogram patterns. Between October, 1993 and December, 1995, 99mTc-DTPA renography was performed in 79 patients with a single ureteral stone. The 99mTc-DTPA renogram pattern was classified into the three types of normal function, obstruction and lower function patterns and the complete stone discharge rate was 93, 63 and 25%, respectively. In addition, diuretic renography using Furosemide was performed in patients with an obstruction pattern and the three renogram patterns of return to the normal curve, a diuretic response and no response were obtained; the complete stone discharge rate was 44, 65.3 and 93%, respectively. From this study, patients with a single ureteral stone with a normal pattern on the regular DTPA renogram and patients with no response pattern on the diuretic renogram, even if in such patients an obstructive pattern was seen on the regular DTPA renogram, seem to be a good candidate for obtaining a high rate of a stone discharge with extracorporeal shock wave lithotripsy (ESWL) treatment in the outpatients basis.