Department of Urology, Hisar Intercontinental Hospital, İstanbul, Turkey.
İstanbul Galata University, İstanbul, Turkey.
Urologia. 2023 May;90(2):371-376. doi: 10.1177/03915603221122613. Epub 2022 Sep 2.
To study was to identify the variables that influence the outcomes of pediatric SWL patients in our clinic and to compare our findings to previously published nomograms.
All children who underwent SWL at a single center between 2005 and 2020 were included in this retrospective study. Depending upon the age and mental state of the children, SWL procedures were performed with or without anesthesia. Data from the hospital information system were obtained on patient characteristics, metabolic evaluation, imaging, SWL details, and post-procedure results, and their correlation with the Onal and Dogan nomograms was evaluated.
The present study included 112 pediatric patients in total. The average age was 8.22 ± 4.9 (83.3 ± 58.1 months, 4 months-16 years), and the median stone size was 9.5 ± 3.2 mm (4-20 mm). Even though there was quite a significant positive correlation between age and the number of shots and the intensity of shots (intensity and number of shots increased with increasing age), there was no statistical difference in the number of sessions and stone-free rates. The number of shots and sessions was significantly lower in patients with hydronephrosis ( = 70) than in those without ( = 42) ( < 0.001). When the stone-free rates of patients without and with hydronephrosis were compared, it was discovered that they were 69.05% and 92.86%, respectively, which was statistically significant ( < 0.01).
It is believed that the nomograms developed for SWL in pediatric patients should be reviewed, and larger, prospective studies should be conducted.
研究目的是确定影响我们诊所小儿体外冲击波碎石术(SWL)患者治疗效果的变量,并将我们的发现与之前发表的列线图进行比较。
本回顾性研究纳入了 2005 年至 2020 年间在单中心接受 SWL 的所有儿童患者。根据儿童的年龄和精神状态,选择在麻醉或非麻醉条件下进行 SWL 治疗。从医院信息系统中获取患者特征、代谢评估、影像学、SWL 细节和治疗后结果的数据,并评估其与 Onal 和 Dogan 列线图的相关性。
本研究共纳入 112 例小儿患者。平均年龄为 8.22±4.9 岁(83.3±58.1 个月至 4 岁-16 岁),结石大小中位数为 9.5±3.2mm(4-20mm)。尽管年龄与碎石次数和碎石强度之间存在显著正相关(年龄越大,碎石次数和强度越高),但碎石治疗次数和结石清除率之间无统计学差异。与无肾积水的患者(n=42)相比,有肾积水的患者(n=70)的碎石次数和治疗次数明显更少(P<0.001)。比较无肾积水和有肾积水患者的结石清除率,发现前者为 69.05%,后者为 92.86%,差异有统计学意义(P<0.01)。
认为应重新评估用于小儿 SWL 的列线图,并开展更大规模的前瞻性研究。