Çocuklarda aynı seansta yapılan oturur ve yatar pozisyondaki ürpdinamik parametrelerin karşılaştırılması
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Date
2006
Authors
Halil, Taner
Journal Title
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Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmanın amacı çocuklarda oturur ve yatar pozisyonun ürodinamik parametrelere ve tanıya etkisini araştırmaktır. Bu amaçla ürodinami endikasyonu konulan olgulara Uludağ Üniversitesi Tıp Fakültesi Çocuk Cerrahisi Anabilim Dalı, Çocuk Ürolojisi Bilim Dalı’nda Mart 2005 ile Kasım 2005 tarihleri arasında iki farklı pozisyonda ardışık ürodinamik test yapıldı. Yaşları üç ile15 arasında değişen 59’u kız 32’si erkek toplam 91 olgu çalışmaya alındı. Olgulara sistometri ve üroflovmetri yatar ve oturur pozisyonda arka arkaya uygulandı. Her olgu ve pozisyon için maksimum idrar akışı, maksimum idrar akışı anında detrusor basıncı, işeme sonrası artık idrar, kapasite, kompliyans, aşırı aktif detrusor varlığı parametreleri ölçüldü. Ortalama maksimum idrar akım hızı yatar pozisyonda 13.301±5.565 ml/s iken, oturur pozisyonda 12.321±5.957 ml/s idi. Maksimum idrar akım hızı anındaki ortalama detrusor basıncı yatar pozisyonda 63.94±26.74 cmH2O iken oturur pozisyonda 74.86±28.76 cmH2O bulundu. İşeme sonrası artık idrar miktarı ortalaması yatar pozisyonda 31.10±76.92 ml, oturur pozisyonda 45.90±91.05 ml bulundu. Ortalama sistometrik kapasite yatar pozisyonda 182.76±79.18 ml iken oturur pozisyonda 186.04±94.89 ml idi. Ortalama kompliyans değeri yatar pozisyonda 10.55±12.90 ml/cmH2O iken oturur pozisyonda 6.42±5.88 ml/cmH2O bulundu. Yatar pozisyonda 37 olguda, oturur pozisyonda ise 56 olguda aşırı aktif detrusor saptandı. İki olguda yatarken saptanan aşırı aktif detrusor oturur pozisyonda bulunamadı. 21 olguda ise otururken saptanan aşırı aktif detrusor yatarken gözlenmedi. Çocukluk çağında yatar ve oturur pozisyonda yapılan sistometri ve flovmetrinin bulgularına etkisi günümüzde hala bilinmemektedir. Literatürde çocuklarla ilgili bu yönde yeterli çalışma yoktur. Erişkinlerde yapılan çalışmalarla çalışmamızın sonuçları karşılaştırıldığında uyumlu ve zıt sonuçlar bulunmuştur. Sonuçları doğrulamak veya reddetmek için çok sayıda değişik merkezli araştırmalara ihtiyaç vardır.
The aim of the study is to search the effect of children’s sitting and lying position in urodynamy to the urodynamics parameters and diagnosis. In our study with this aim we made the urodynamy in consecutively lying and sitting position to patients who had urodynamy indication. The study was made in The Medical Faculty of Uludag University, Department of Pediatric Surgery, Division of Pediatric Urology between March -November 2005. 91 patient’s ages were between 3 and 15. Among them 59 was girl and 32 was boy. Systometry and uroflowmetry was applied consecutively in sitting and lying position. For every patient and position the parameters were maximum urinary flow, detrusor pressure in maximum urinary flow, residual urine after urinating, complains, capacity and detrusor overactivity. Average maximum urine flow is 13.301±5.565 ml/s in lying position and 12.321±5.957 ml/s in sitting position. Average detrusor pressure in maximum urine flow is 63.94±26.74 cmH2O in lying position and 74.86±28.76 cmH2O in sitting position. Average residual urine after urinating is 31.10±76.92 ml in lying and 45.90±91.05 ml in sitting position. Average systometric capacity is 182.76±79.18 ml in lying position and 186.04±94.89 ml in sitting position. Average complains is 10.55±12.90 ml/cmH2O in lying and 6.42±5.88 ml/cmH2O in sitting position. Detrusor overactivity was estimated in lying position in 37 patients and in sitting position in 56 patients. In two patients in lying position detrusor overactivity was detected, but was not detected in lying position. Otherwise in 21 patients the detrusor overactivity was detected in sitting position but was not detected in lying position. In childhood by systometry and uroflowmetry the sitting and lying positions effect on test parameters haven’t been described yet. There is no enough literature evidence about this study in children. Our studies conclusions were compared with adult studies. There were found opposite and correlate conclusions. To verify or to refuse the conclusions, we need multicentric studies.
The aim of the study is to search the effect of children’s sitting and lying position in urodynamy to the urodynamics parameters and diagnosis. In our study with this aim we made the urodynamy in consecutively lying and sitting position to patients who had urodynamy indication. The study was made in The Medical Faculty of Uludag University, Department of Pediatric Surgery, Division of Pediatric Urology between March -November 2005. 91 patient’s ages were between 3 and 15. Among them 59 was girl and 32 was boy. Systometry and uroflowmetry was applied consecutively in sitting and lying position. For every patient and position the parameters were maximum urinary flow, detrusor pressure in maximum urinary flow, residual urine after urinating, complains, capacity and detrusor overactivity. Average maximum urine flow is 13.301±5.565 ml/s in lying position and 12.321±5.957 ml/s in sitting position. Average detrusor pressure in maximum urine flow is 63.94±26.74 cmH2O in lying position and 74.86±28.76 cmH2O in sitting position. Average residual urine after urinating is 31.10±76.92 ml in lying and 45.90±91.05 ml in sitting position. Average systometric capacity is 182.76±79.18 ml in lying position and 186.04±94.89 ml in sitting position. Average complains is 10.55±12.90 ml/cmH2O in lying and 6.42±5.88 ml/cmH2O in sitting position. Detrusor overactivity was estimated in lying position in 37 patients and in sitting position in 56 patients. In two patients in lying position detrusor overactivity was detected, but was not detected in lying position. Otherwise in 21 patients the detrusor overactivity was detected in sitting position but was not detected in lying position. In childhood by systometry and uroflowmetry the sitting and lying positions effect on test parameters haven’t been described yet. There is no enough literature evidence about this study in children. Our studies conclusions were compared with adult studies. There were found opposite and correlate conclusions. To verify or to refuse the conclusions, we need multicentric studies.
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Keywords
Ürodinami, Oturur, Yatar, Pozisyon, Çocuk, Urodynamics, Sitting, Lying, Position, Child
Citation
Halil, T. (2006). Çocuklarda aynı seansta yapılan oturur ve yatar pozisyondaki ürpdinamik parametrelerin karşılaştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.