文章詳目資料

中華民國泌尿科醫學會雜誌

  • 加入收藏
  • 下載文章
篇名 Calculi in the Patients with Urinary Diversion: 5-Year Experience in Tri-Service General Hospital
卷期 6:2
並列篇名 尿液分流術後病人的結石治療:三軍總醫院五年之經驗
作者 陳鼎源于大雄蔡永成李祥生孫光煥程千里王曉暹馮超傑馬正平楊泰和
頁次 97-102
關鍵字 尿液分流術尿路結石感染性結石體外震波碎石術urinary diversionurinary calculistruvite stoneESWLTSCI
出刊日期 199506

中文摘要

在作過尿液分流術的病人中,有很高的機率會有尿路結石。這類病人雖然不多,但反覆病可造成嚴重併發症及後遺症。本文回顧性整理本院(三軍總醫院)過去五年中,作過尿液分流術後產生尿路結石的病人共十一名(八男,三女)約佔全部尿液分流術病人的十六、七%(11/66);在迴腸迴路造口術病人中為十五、七%(8/51)。這些病人在術前並無尿路結石之病史。施行尿液分流術的病因有膀胱移形上皮癌八例,神經性膀胱三例。至於手術的方法以迴腸迴路造口術最多(八例)。這些病人常有反覆尿路感染,甚至敗血症的病史。總計十九單位結石發生且在本院接受治療。依結石之大小、位置不同而採取不同的治療方法。開刀取石術曾用於三例較大、較複雜之結石(如鹿角石)。但這類病人有較高之併發症發生率及較多之住院天數。至於體外震波碎石術已經成為主要的治療方法,尤其適用於簡單、不大的結石。此法雖可達到很好的成功率,但仍有很高再發率。故仍需適當的水份攝取及敏感的抗生素治療,以預防結石的再生。

英文摘要

The relationship between urinary diversion and calculi formation has been well documented. This is a retrospective review of the patients who had calculi formation after the urinary diversion in the past five years and visited our hospital. The incidence of calculi formation was 16.7% (11/66) in all patients with diversion and 15.7% (8/51) among these patients having ileal conduit patients. None of these patients (8 men and 3 women) had history of urinary stone before diversion. The causes of diversion included TCC (transitional cell carcinoma) of bladder (8/11) and neurogenic baldder (3/11). ileal conduit remained the most popular method of diversion (8/11). Urinary tract infection and sepsis were common in these patients. Totally 19 units of calculi were treated differently according to the size and location of the calculi. Larger and complicated renal stones were managed with open surgery, but complication rate was higher and hospital days were longer. Extracorporeal shock wave lithotripsy (ESWL) became the first choice in the majority of simple stone units to achieve high stone free rate (85%), but the follow-up found high recurrent rate (7/11). Adequate hydration and effective antibiotics play an important role in the prevention of calculi recurrence.

相關文獻