尿路結石に対するESWLの治療成績 - 単一結石911例の部位および大きさによる成績の比較検討 -

Abstract

ESWLを施行し, 追跡可能であった911例の単一結石について, 1)男性では女性に比し, 尿管結石の頻度が高かった.2)腎盂・腎杯に存在する結石に対するESWLの成績が最も良好で, 20 mm以下で87%の成功率を得た.3) ESWL成績不良部位は尿管で, 嵌頓結石症例では結石サイズが小さくとも, TULやD-Jステントカテーテル留置下でのESWLを行うべきである

At Osaka City University Hospital, we performed extracorporeal shock-wave lithotripsy (ESWL) for 1277 patients in a total of 1788 sessions using Dornier kidney lithotripter Model HM III from July, 1985 to the end of December, 1988. Among the patients with a solitary stone, 911 cases were available for the follow-up study and we have compared the results among these cases in respect to the stone location and size. The results obtained were as follows: the ratio of kidney stone to ureter stone was found to be 2.2:1 in male, and 3.8:1 in female patients. This indicates that ureter stones are more frequently found in male than in female patients. In addition, we compared the size of kidney stones found in the patients including 415 male and 243 female patients. Stones larger than 20 mm were more frequently found in female than in male patients. Moreover, a stone composition study of these patients showed that the contents of both phosphate calcium and magnesium ammonium phosphate were higher in female than in male patients. ESWL performed against stones at pelvis and calyces exhibited the best results. The results obtained with the stones less than 20 mm in diameter were especially favorable with a success rate of 100% for the stones less than 10 mm and 83% for the stones 10-20 mm, in diameter, while the results with the stones larger than 20 mm in diameter were rather poor with a success rate of 31%. ESWL performed against ureter stones showed poor results with a success rate of 63% for the stones smaller than 20 mm in diameter.