コアグラム腎盂切石術の検討

Abstract

1984年までの約4年間にコアグラム腎盂切石術を施行した20例中4例に腎切石術を併用したが, 残石は4例(20%)に認められた.肝炎などの副作用は, 1例も見られなかった.コアグラムの形成に関して, トロンビン濃度を変化させても張力に有意差はなく, カルシウム添加によって, 張力は4倍に増強した.凝固時間に関しては, トロンビン濃度が高いほど凝固時間は短縮した.また, フィブリノーゲンとトロンビンは, 腎外で混和した方が, より良いコアグラムを得られた

Coagulum pyelolithotomy was carried out on 20 patients from January, 1980 to April 1984. Nephrolithotomy was jointly carried out on 4 of them, but residual stones were observed in 4 cases (20%). No side effect such as hepatitis was observed in any cases. While inferring the cause of residue, experimental study was made on tension, coagulation time and mixing method in respect to coagulum formation. In the experiment on tension, no significant difference was observed when thrombin concentration was changed, but when calcium was added, tension increased 4 fold. As thrombin concentration rose, so shortened the coagulation time. It was inferred that a better coagulum is made available if fibrinogen and thrombin are mixed outside the kidney.