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長期臨床 戰傷患者의 尿結石에 關한 硏究

長期臨床 戰傷患者의 尿結石에 關한 硏究
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(A) Study of Urinary Stone in Long Term Recumbent Patient with Trauma
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대학원 의학과
이화여자대학교 대학원
1975년 1월부터 1982년 6월까지 만7년 6개월에 걸쳐 원호병원 방사선과에서 전상으로 인한 외상환자 중 단순요로 촬영상및 배설성 요로촬영상에 의해 요결석이 확진된 88례를 대상으로 요결석의 발견위치, 발견기간, 재발율, 요결석형성요인 및 손상부위와의 관계를 분석 연구하였다. 손상부위는 뇌척수손상, 골절손상 및 이상의 손상과는 무관하게 심한 창상으로 인하여 장기간 비가동성 와상상태에 있게 된 기타손상의 3군으로 구분하여 연구하므로서 다음과 같은 결론을 얻었다. 1. 연령분포는 23세에서 56세까지 였고, 20대가 28례로 가장 많았다. 2. 외상유형별로는 88례 중 척수손상 74례 (84.1%), 골절손상 8례(9.1%), 기타 6례 (6.8 %)였다. 3. 요결석 발견위치는 방광 61례 (69.3%), 신장 23례(26.1%) 요관 12례(13.6%)이었다. 4. 요결석 발견기간은 뇌척수손상시 초기발견이 26례(35.2%)로 가장 많았으나, 그 외의 손상시 후기발견이 많았다. 5. 요결석 재발율은 28례 (31.8%)였고, 뇌척수손상시 27례(36.5 %)로 가장 높았으며, 요결석 재발위치는 제1차 발생때와 유사하여 방광 18례(64.3%), 신장 7례(25.0%), 요관 3례(10 .7%) 이었다. 6. 요결석형성 요인으로 생각되는 감염이 84.1%로 가장 많았고, 신경인성 방광이 77.3%, 비뇨기계 외과적 수술이 58.0 %, 및 장기간 유치카테터가 47.0 % 이었다.;The evaluation of urinary stone was conducted in a group of 88 urinary stone patients who received trauma with cerebrospinal cord injury, fracture, and othrs. These patient was diagnosed by KUB and excretory urograms at the Veterans Hospital during a seven and half years from January 1975 to June 1982. The urinary stone was discussed according to the type of injury, favorable site, time element, recurrency and factors which were able to be act as a urinary stone formation. The results were as follow: 1. Age distribution was 23 to 56 years old. The third decade was 28 pateint (31.8%). 2. The occurence of urinary stone according to injury was 74 (84.l%) in cerebrospinal cord injury, 8 (9.l%) in fracture and 6 (6.8%) in others. 3. Favorable site of urinary stone was most common in urinary bladder 61 (69.3%), next in kidney 23 (26.l%) and in ureter 12 (13.6%). 4. In cerebrospinal cord injury, early urinary stone shown high incidence as 26 (35.l%). Other groups shown high incidence in late period. 5. Overall incidence of recurrent urinary stone was 31.8%. In cerebrospinal cord injury, recurrent rate was as much as 36.1% Favorable site was similar to primary stone. 6. The factors which were considered to related urinary stone formation were as follow: 84.l% in urinary tract infection, 77.35% in neuropathic bladder, 58.0% in previous urological surgery and 47.0% in indwelling catheter.
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