상부요관결석의 체외충격파 쇄석술시 Pushback효과의 임상적 고찰

다국어 초록 (Multilingual Abstract)

Extracorporeal shock wave lithotripsy(ESWL) was performed in 122cases with proximal ureteral calculi managed by the Northgate SD-3 lithotriptor using ultrasound stone localization from June, 1989 to May,1990. Author completed 122 cases with proximal ureteral calculi in 3 different categories of treatment: push back, Insitu, Insitu with open-ended push back ureteral catheter(failure of push back).
Insitu treatment was performed in 68 cases without instrumentation and in 27 cases after placement of open-ended push back ureteral cathether below the stone. Retrograde stone manipulation was performed in 54 cases immediately before ESWL. In 27 eases of proximal ureteral stone were manipulated successfully into the kidney using push back ureteral cathether
The success rate of treatment (rate free of stone plus clinically insignificant residual stone fragments) was achieved 100% in success of push back, 98.5% in Insitu and 88.9% in Insitu with push back cathether below the stone(failure of push back.) Total mean success rate was 96.7%.
The success rate was significantly greater if the stone was manipulated into the kidney before ESWL. The total average shock wave were achieved 1667 w in push back, 3007 w in Insitu and 4133 w in Insitu with push back cathether below the stone. Significantly less average shock wave was required for complete disintergration if the stone was manipulated into the kidney. Ureteral perforations were developed in 2 cases of retrograde manipulation, all which were managed conservatively.
Ureterolithotomy was required in 4 cases(3.3%) of 122 proximal ureteral calculi.
An attempt at manipulation of proximal ureteral calculi back to the kidney will be cost effective clinical algorithm for treatment of the proximal ureteral calculi that minimized patients morbidity which yielding a high rate of effective therapy.

목차 (Table of Contents)

• 목차
• Abstract = 1
• Ⅰ. 서론 = 3
• Ⅱ. 관찰대상 및 방법 = 4
• Ⅲ. 관찰결과 = 6
• Ⅳ. 고안 = 7
• Ⅴ. 결론 = 9
• Reference = 10