Perkütan Nefrolitotomi Yapılan Çocuk Hastalarda Kanamayı Etkileyen Faktörlerin Araştırılması

Year 2019, Volume: 5 Issue: 3, 489 - 496, 01.01.2019

Murat Uçar Erdem Kısa Cem Yücel Tufan Süelözgen Yusuf Özlem İlbey

Abstract

Amaç: Erişkin hastalarda olduğu gibi çocuk hastaların böbrek taşı tedavisinde de etkili ve güvenle kullanılan perkütan nefrolitotomi PNL ameliyatının sık görülen komplikasyonlarından birisi kanamadır. Bu retrospektif çalışma ile pediatrik PNL olgularında kanamayı etkileyen faktörlerin belirlenmesini amaçladık.Gereç ve Yöntemler: Ocak 2010 ve Mayıs 2018 tarihleri arasında kliniğimizde 57 çocuk hastaya 24 kız, 33 erkek uygulanan 61 pediatrik PNL ameliyatının sonuçları retrospektif olarak değerlendirildi. Bulgular: Hasta popülasyonunun medyan yaşı 13 olarak saptandı. Hastalarımızın medyan taş yükü 420 mm2 iken, taşların %47,5’i kompleks taş özelliğindeydi. Hastaların %88,5’ine tek akses yapıldı ve akseslerin %83,6’sı infrakostal seviyeden gerçekleştirildi. PNL prosedürlerinden sonra ortalama hemoglobin ve hematokrit Htc düşüşü sırasıyla 1,1±1,15 mg/dl ve %3,23±3,26 olarak bulundu. Kan transfüzyonu yapılan hastalarda n=4, %6,5 hemoglobin ve Htcʼde ortalama düşüş sırasıyla 3,1±0,8 mg/dl ve %10,3±2,8 olarak saptandı. Medyan operasyon süresi 90 dk olarak saptandı. Çalışmamızda sadece operasyon süresinin uzun olması, pediatrik PNL olgularında artmış kan kaybıyla anlamlı olarak ilişkili bulundu p

Keywords

Nefrolitiyazis, Çocuk, Perkutan nefrolitotomi, Komplikasyon

Investigation of Factors Affecting Bleeding in Children with Percutaneous Nephrolithotomy

Abstract

Objective: One of the most common complications of percutaneous nephrolithotomy PNL , which is also used in the treatment of kidney stones in pediatric patients as in adult patients, is bleeding. In this retrospective study, we aimed to determine the factors affecting bleeding which is a complication of pediatric percutaneous nephrolithotomy. Material and Methods: The results of 61 pediatric PNL operations performed between January 2010 and May 2018 in 57 pediatric patients 24 girls, 33 boys at our clinic were evaluated retrospectively.Results: The median age of the patients was 13 years. The median stone load of our patients was 420 mm2 and 47.5% of the stones were complex stones. Single access was performed in 88.5% of the patients and 83.6% of the accesses were performed at the infracostal level. After PNL procedures, the mean hemoglobin and Htc decrease were 1.1±1.15 mg/dl and 3.23±3.26%, respectively. In patients with blood transfusion n=4, 6.5% the mean decrease in hemoglobin and Htc was 3.1±0.8 mg/dl and 10.3±2.8%, respectively. The median operation time was 90 minutes. Univariate linear regression analysis found that longer operation time p

Keywords

Nephrolithiasis, Pediatrics, Percutaneous nephrolithotomy, Complication

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