요관결석에 대한 요관경하 배석술: 부분마취와 척추마취의 비교
Ureteroscopic Manipulation for Ureteral Calculi: Comparison between Local and Spinal Anesthesia
소속 상세정보
박희철/Hi Cheol Park
KMID : 0358319970380101052
Abstract
결론
이상의 결과를 종합하면 요관경하 배석술시 척추마취와 부분마취상태에서 성공률이나 합
병증에 통계학적으로 유의한 차이가 없었으며, 부분마취하의 요관경하 배석술은 입원기간을
줄일수 있으며, 전신이나 척추마취를 함으로써 오는 환자의 신체적 부담과 시간, 경제적인
부담을 줄일 수 있어 외래에서 시행할 수 있는 부분마취하 요관경하 배석술이 요관결석의 1
차적 치료방법으로서 이용될 수 있을 것으로 생각된다.
#초록#
Ureteroscopic removal of urethral calculi is an established treatment nowadays and
can be performed under direct vision using flexible grasping forceps, stone baskets,
electrohydraulic lithotriptor with increased safety and efficacy. In this study we tried to
analyse the exact role of ureteroscopic manipulation between spinal and local anesthesia.
In 127 ureteroscopic stone removal procedures performed from May 1994 to December
1996, under local anesthesia (55 case) and spinal anesthesia (72 case), the success rate
and complications were measured. The sucess was defined to complete removal of stone
or residual stone less than 1 mm. The success rate of the ureteroscopic manipulation
was 80.3% (102/127), 81.9% (59/72), 78.4% (43/55) in total, spinal and local anesthesia,
respectively. The success rate of the ureteroscopic manipulation was 75% (3/4), 71.4%
(5/7), 83.6% (51/61) in upper, middle and lower ureter stones, under spinal anesthesia
and 64.3% (9/14), 66.7% (6/9), 87.5% (28/32) under local anesthesia.
According to the size of the stone, the success rate was 89.7% (35/39), 68.2% (15/22),
81.8% (9/)1) under spinal anesthesia when it was less than 5mm, 6 to 10 mm, and
larger than 10 mm, 86.7% (26/30), 68.2% (Is/22), 66.7% (2/3) under local anesthesia.
Complication was found in 16.6% of cases of the spinal anesthetic procedures and it was
21.8% of those of the local anesthetic procedures.
These observations showed that ureteroscopic removal of ureteral calculi, when
performed without spinal anesthesia, does not increase the risk of complications or
compromise the results of treatment.
키워드
Ureter stone; Ureteroscopic manipulation; Anesthesia;
원문 및 링크아웃 정보
등재저널 정보