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[持续性甲状旁腺功能亢进患者肾移植术后肾移植结石行体外冲击波碎石术治疗:一例报告]

[Renal transplant calculi in a renal allograft treated with extracorporeal shock wave lithotripsy in a patient with persistent hyperparathyroidism: a case report].

作者信息

Konya E, Hara Y, Ikegami M, Nishioka T, Akiyama T, Kurita T, Kohri K, Matsuura T

机构信息

Department of Urology, Kinki University School of Medicine.

出版信息

Nihon Hinyokika Gakkai Zasshi. 1995 Jun;86(6):1185-8. doi: 10.5980/jpnjurol1989.86.1185.

Abstract

Between 1984 and 1991, six of 105 renal transplant recipients at our institution formed urinary tract calculi after transplantation (5.7%). In these 6 patients, one case of nephrolithiasis in a transplanted kidney was treated with extracorporeal shock wave lithotripsy (ESWL). A 37-year-old woman underwent cadaveric renal transplantation twenty months before, and her renal function remained stable. However calculi in the transplanted kidney and bladder were formed and ESWL was used for the treatment of the renal calculus in the transplanted kidney. She was discharged from the hospital two weeks postoperatively while passing small gravel in the urine after successful fragmentation of the calculus without any major complications. As follow-up KUB film two weeks later demonstrated that all stone fragments had been passed, but she was treated again by ESWL four months later because IVP films four weeks later revealed recurrent calculi in the transplanted kidney. The stones were fragmented successfully and spontaneously passed with voiding. Moreover we performed total parathyroidectomy with autotransplantation for persistent hyperparathyroidism, with subsequent good clinical results.

摘要

1984年至1991年间,在我们机构接受肾移植的105名受者中有6人(5.7%)在移植后形成了尿路结石。在这6例患者中,1例移植肾肾结石接受了体外冲击波碎石术(ESWL)治疗。一名37岁女性在20个月前接受了尸体肾移植,其肾功能保持稳定。然而,移植肾和膀胱中形成了结石,ESWL被用于治疗移植肾中的肾结石。术后两周她出院,结石成功破碎后尿液中有小碎石排出,无任何重大并发症。两周后的随访腹部平片显示所有结石碎片均已排出,但四周后的静脉肾盂造影显示移植肾中复发结石,四个月后她再次接受了ESWL治疗。结石成功破碎并随排尿自行排出。此外,我们对持续性甲状旁腺功能亢进症患者进行了甲状旁腺全切术并自体移植,随后临床效果良好。

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