0-2 Yaş Grubu Üriner Sistem Taş Hastalığında Vücut Dışı Şok Dalga Tedavisinde Başarıyı Etkileyen Faktörler
Kartal, İbrahim Güven
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In the recent years, stone disease, which is increasing on children, has become a serious health problem for the infants as well. Our hypothesis claims that extracorporeal shock wave lithotripsy (SWL) treatment can be applied succesfully on younger ages. For that purpose, factors which might have effect on success, the efficiency and the reliablity of SWL have been examined on stone disease treatment of patients between the ages of 0-2. Between January 2009-September 2013, children under the age of 18, 402 renal unit which treated with SWL in our clinic, have been scanned reprospectively and among all, 149 patients between the ages 0-2 have been included in research. Patients in this group have been compared with patients with older ages according to overall stone free rate, and in order to foresee the success in research group; analysis with single, multiple variables as well as ROC curves have been used and statictically evaluated. After the first session, success rate was %70,5, and between the ages 0-1 success rate was %77,2, it has been examined that SWL’s effectiveness on younger ages were signaficantly higher compared to older ages (p=˂0,001 ve p=0,003). On infants; overall stone free rate has been measured %81,9, and between the ages 0-1 rate has been measured as %87,7 and on younger ages success rate has been measured signaficalty higher (p=˂0,001, p=0,001). SWL success on infants and age group of 0-1, single stone and stone size have been found significant, on the other hand single stone has been detected as independent risk factor (on infants; odss ratio [OR]; 6,173, confidence interval; 1,819-20,946, p=0,004, between the ages 0-1; OR; 13,838, confidence interval; 0,973-196,786,p=0,05). In ROC analysis which was done for stone size, optimum cut-off point has been found as 10mm (area under the curve: 0,683, %59 sensitivity, %70 spesifity, p=0,002) Only 1 infant had urinary tract infection which responded to medical treatment,was observed on a complication. As a result of our research, it has been found that SWL can be used reliably has high rate of success and lower rate of complications on the treatment of stone disease for the 0-2 age group, especially for single stone and smaller than 10 mm.