EDAP LT-01 Plus를 이용한 통일 충격파량하에서 충격파강도에 따른 신석분쇄율의 비교
Comparison of the degree of Fragmentation according to the Various Level of Wave Power in the Same Storage with EDAP LT-01 Plus
박진오, 권경철,
소속 상세정보
박진오 ( )
고려대학교 의과대학 피부과학교실
권경철 ( )
고려대학교 의과대학 비뇨기과학교실
KMID : 0358319990400020156
Abstract
서론
충격파쇄석술은 1980년 Chaussy 등에 의해 처음으로 신석 치료에 임상적으로 사용되었으
며, 현재 요석의 비침습적인 치료법으로서 널리 이용되고 있다. 초기에는 동통으로 인하여
마취를 필요로 하였으나, 개량된 충격파쇄석기는 마취 및 입원이 필요치 않고 높은 성공률
과 적은 합병증을 보이고 있다. 충격파쇄석술은 물론 기종에 따라 약간씩의 차이는 있지만
대부분의 경우 마취없이 시행하며 시술 중 발생하는 동통으로 인하여 충격파의 강도를 줄여
서 시술하는 경우가 많다. 이 경우 충격파의 총횟수를 증가시켜 같은 충격 파량으로 충격파
쇄석술을 시행하였을 때, 요석분쇄율의 차이가 없이 동일한 효과를 나타내는지에 대해서는
정확히 연구된 바가 없다.
1994년 본원에서는 충격파쇄석술시 동일한 충격파량(storage)하에서도 가해지는 충격파강
도를 다르게 하였을 때 실험석고의 분쇄율에 차이가 있음을 보고한 바 있다. 이에 저자들은
충격파강도에 따라 실제 요석분쇄율에 차이가 있는지 임상적으로 살펴보았다.
Purpose : Many patients complains of pain during shock wave lithotripsy(SWL). For
this reason, SWL frequently is performed in decreased power setting of the shock wave
and it could result in decreased fragmentation rate. We evaluated the fragmentation
rates at different shock wave power in the same storage that resulted in the same
amount of energy delivered.
Materials and Methods : From 1995 to 1997, a total of 97 renal stones less than 2㎝
in diameter were treated at the same sessional storage of 90 with various shock wave
power(46%, 54%, 64%, 74%, 87%, 100%). In case of EDAP device the energy delivered
to disintegrate the stone is expressed as storage, that is calculated by power x duration
x rate. The patients were treated by a power of 46 to 100 per cent at 10 impulses per
second during the various treatment time to deliver the same storage. Complete to
fragmentation was defined as no residual fragments or fragments less than 3㎜ on KUB
films at 2 weeks after treatment, otherwise another session was delivered. At 3 months
after first session incomplete fragmentation was regarded as failure. Data were collected
retrospectively and included the size of stones, the number of treatments and complete
fragmentation rate. The results were compared between low power group at 46, 54, 64
per cent and high power group at 74, 87, 100 per cent of shock wave power setting.
Statistical comparison were performed by the student's t-test.
Results : The complete fragmentation late was 74.2 per cent in 97 renal stones. The
mean size of stones was 1.04±0.52㎝ and the mean number of treatments was 3.6
sessions. For low and high power group the mean size of stones were 1.10±0.62㎝, 1.02
±0.54㎝, respectively(p>0.05) and the complete fragmentation rate was 50.0 per cent and
86.4 per cent, respectively(p<0.05). The mean numbers of session were 5.4±2.5 and 2.8
±1.7, respectively(p<0.05). In cases of the complete fragmentation of stones the mean
numbers of session between low and high power group were 5.2±2.3 and 2.3±0.6,
respectively(p<0.05). Posttreatment complications, such as prolonged gross hematuria,
perirenal hematoma or steinstrasse, was not seen in both groups.
Conclusions : The above results indicate that the shock wave power is more
Important in fragmentation of urinary stone than the number of shock wave, even at
same storage.
키워드
Shock wave lithotripsy; Shock wave power; Fragmentation rate;
원문 및 링크아웃 정보
등재저널 정보