圧電式砕石装置(Piezolith)による尿路結石の治療経験

Abstract

1) 133例の尿路結石患者に対し, PiezolithによるESWLを行った.腎結石, 尿管結石, 膀胱結石に対する有効率はそれぞれ97.8%, 70.6%, 100%と満足すべき結果をえた.2)軽度の疼痛, 血尿以外重篤な副作用はなかった.3) 37例の腎結石に尿管ステントを留置してESWLを施行した.尿管ステントによりstone street形成時も尿流を確保でき, 珊瑚状結石のような大きな結石の場合有用であった.尿管ステントの副作用としてステント周囲への結石付着症例を5例経験した.予防としてステント留置期間を3ヵ月以内に止めればよいと思われた

A total of 133 stones in renoureteral and bladder units from 122 patients, 8 to 80 years old, were treated by extracorporeal shock wave lithotripsy (ESWL) with the Wolf Piezolith device from November 1989 through December 1990. The 133 stones involved renal stones (91), ureter stones (34) and bladder stones (9). The number of shock waves per session was up to 4, 000 shots, the mean number of shots was 3, 120. Neither anesthesia nor analgesic agents were used except for epidural anesthesia on 10 and intramuscular analgesics on 8 patients. Fragmentation into particles 4 mm in size or less occurred in 89 of the 91 renal stones (97.8%), 24 of the 34 ureteral stones (70.6%) and 8 of the 8 bladder stones (100%). The mean numbers of treatment on each stone were 3.2, 1.8 and 1.8, respectively. Ultrasound localization restricted treatment of ureteral stones to the most proximal and distal fourth of the ureter.