Tuncer Murat, Kafkaslı Alper, Can Utku, Çoşkun Alper, Eryıldırım Bilal, Sarica Kemal
Dr. Lutfi Kirdar Training and Research Hospital Urology Clinic, Cevizli mevkii, Cevizli mah. Şemsi Denizer cad. D 100, Kartal, 34890, Istanbul, Turkey.
Department of Urology, Biruni University School of Medicine, Istanbul, Turkey.
Urolithiasis. 2021 Aug;49(4):377-383. doi: 10.1007/s00240-021-01246-6. Epub 2021 Mar 11.
The aim of the study is to compare the effects of varying frequency rates (60, 90, and 120 SWs/min) on the stone free rate and complication rates of pediatric SWL. 75 children with renal stones were divided into 3 groups depending on the SW frequency applied. Group 1. low (60 SWs/min), Group 2. intermediate (90 SWs/min) and Group 3. high (120 SWs/min) frequency. Patient demographics (age, gender, BMI), stone (location, size, laterality), and SWL (total number of sessions, shock waves, anesthesia time) related parameters were documented. Postoperative success, complication rates, and the need for additional interventions were comparatively evaluated. There was no significant difference regarding the patient demographics, stone characteristics, SWL parameters, postoperative complication rates, need for additional interventions as well as efficacy quotient between all (p > 0.05). The stone free rates were significantly lower in cases with high frequency, whereas there was no statistically significant difference between the intermediate and low frequency groups (p > 0.05). Although not statistically significant; low frequency application may be more advantageous than intermediate as lower number of high energy shock waves required which may cause less tissue damage. On the other hand, despite lack of a statistically significant difference, relatively longer anesthesia time may constitute a disadvantage for lower frequency. We believe that considering the growing nature of the child kidney application of low frequency (60 SWs/min) will be advantageous. However, we believe that further studies with larger series of cases are needed to make a clear-cut differentiation between low and intermediate SW applications.
本研究的目的是比较不同频率（60、90和120次冲击/分钟）对小儿体外冲击波碎石术（SWL）的结石清除率和并发症发生率的影响。75例肾结石患儿根据所应用的冲击波频率分为3组。第1组.低频率（60次冲击/分钟），第2组.中等频率（90次冲击/分钟），第3组.高频率（120次冲击/分钟）。记录了患者的人口统计学特征（年龄、性别、体重指数）、结石（位置、大小、侧别）以及与SWL相关的参数（总治疗次数、冲击波次数、麻醉时间）。对术后成功率、并发症发生率以及额外干预的必要性进行了比较评估。在所有患者的人口统计学特征、结石特征、SWL参数、术后并发症发生率、额外干预的必要性以及疗效商数方面，均无显著差异（p>0.05）。高频率组的结石清除率显著较低，而中等频率组和低频率组之间无统计学显著差异（p>0.05）。虽然无统计学显著差异；但低频率应用可能比中等频率更具优势，因为所需的高能冲击波数量较少，可能对组织造成的损伤较小。另一方面，尽管无统计学显著差异，但相对较长的麻醉时间可能是低频率应用的一个不利因素。我们认为，考虑到儿童肾脏的生长特性，应用低频率（60次冲击/分钟）将具有优势。然而，我们认为需要进行更大样本量的进一步研究，以明确区分低频率和中等频率的SW应用。
