Genellikle orta ya\u015f ve \u00fczeri bireylerde g\u00f6r\u00fcld\u00fc\u011f\u00fc bilinen ta\u015f hastal\u0131\u011f\u0131 konusunda uyar\u0131larda bulunan \u00dcroloji Op. Dr. Cem Alan, hastal\u0131\u011f\u0131n \u00e7ocuklarda da rastlan\u0131labilece\u011fini kaydetti.<\/p>\n
VM Medical Park Kocaeli Hastanesi Kocaeli \u00dcroloji Uzman\u0131 Op. Dr. Cem Alan, pediatrik \u00fcriner sistem ta\u015f hastal\u0131\u011f\u0131n\u0131n \u00f6zellikle T\u00fcrkiye, Pakistan, baz\u0131 G\u00fcney Asya \u00fclkeleri gibi endemik b\u00f6lgeler ile \u00f6zellikle Do\u011fu ve G\u00fcneydo\u011fu b\u00f6lgesinde olduk\u00e7a yayg\u0131n bir hastal\u0131k oldu\u011funu s\u00f6yledi. Hastal\u0131\u011f\u0131n dikkatli tan\u0131 ile tedavisinin yap\u0131lmas\u0131 gerekti\u011fini belirten Op. Dr. Alan, tekrarlama e\u011filimi olmas\u0131 nedeniyle altta yatan metabolik hastal\u0131klar\u0131n ise mutlaka ortaya \u00e7\u0131kar\u0131lmas\u0131 gerekti\u011fine dikkat \u00e7ekti.<\/p>\n
Ta\u015f olu\u015fumunun farkl\u0131 t\u00fcrleri var<\/p>\n
Ta\u015f olu\u015fumunun farkl\u0131 t\u00fcrlerde meydana gelebilece\u011fini s\u00f6yleyen Op. Dr. Cem Alan, \u201cKalsiyum, sistin, \u00fcrik asit veya enfeksiyon ta\u015flar\u0131 gibi birka\u00e7 t\u00fcr\u00fc vard\u0131r. \u00c7ocuklarda en s\u0131k g\u00f6r\u00fclen ta\u015f cinsi kalsiyum i\u00e7eren ta\u015flard\u0131r. Bunlar\u0131n y\u00fczde 52-80\u2019ni kalsiyum oksalat-fosfat ta\u015flar\u0131 olu\u015fturur. Daha k\u00fc\u00e7\u00fck \u00e7ocuklarda ise enfeksiyon ta\u015flar\u0131 daha s\u0131k g\u00f6r\u00fclmektedir. G\u00fcn\u00fcm\u00fczde bilinen en \u00f6nemli sebeplerden biri idrar ile v\u00fccuttan at\u0131lan kalsiyum, oksalat, \u00fcrik asit ve sistin molek\u00fcllerinin y\u00fcksek yo\u011funlukta olmas\u0131 ile idrar yollar\u0131nda birikmesiyle birlikte bunlar\u0131 bir araya gelip birle\u015fmesini engelleyen fakt\u00f6rlerin idrardaki miktarlar\u0131n\u0131n azalmas\u0131d\u0131r. Ayr\u0131ca idrar PH de\u011fi\u015fiklikleri, anatomik bozukluklar, enfeksiyonlar da ta\u015f olu\u015fumunu kolayla\u015ft\u0131rmaktad\u0131r. Diyetle fazla kalsiyum al\u0131m\u0131, idrar PH de\u011ferinin asidik olmas\u0131 \u00f6nemli sebepler aras\u0131ndad\u0131r. \u0130drar yollar\u0131nda herhangi bir t\u0131kan\u0131kl\u0131k veya anatomik\/i\u015flevsel bozukluk, idrar yolu enefeksiyon riskini art\u0131rarak \u00e7o\u011falan bakterilerin etkileri ile \u00e7ocukluk \u00e7a\u011f\u0131 ta\u015f hastal\u0131\u011f\u0131n y\u00fczde 5\u2019ini olu\u015fturan enefeksiyon ta\u015flar\u0131n\u0131n ana sebeplerindendir\u201c dedi.<\/p>\n
Belirtiler ya\u015fa g\u00f6re de\u011fi\u015fkenlik g\u00f6sterebilir<\/p>\n
Op. Dr. Cem Alan hastal\u0131\u011f\u0131n belirtileri hakk\u0131nda bilgi vererek, \u201cKlinik ba\u015fvuru semptomlar\u0131 ya\u015fa g\u00f6re de\u011fi\u015fmekle beraber b\u00fcy\u00fck \u00e7ocuklarda yan a\u011fr\u0131s\u0131 ve idrarda kanama daha \u00e7ok g\u00f6r\u00fcl\u00fcrken, k\u00fc\u00e7\u00fck \u00e7ocuklarda daha \u00e7ok kar\u0131n a\u011fr\u0131s\u0131, mide bulant\u0131s\u0131, kusma, huzursuzluk gibi \u00f6zg\u00fcl olmayan semptomlar g\u00f6r\u00fclmektedir. B\u00fct\u00fcn hastalarda mikroskobik idrarda kanama g\u00f6r\u00fclmekte, baz\u0131 \u00e7ocuklarda ise \u00fcriner sistem enefeksiyonu ta\u015f hastal\u0131\u011f\u0131n\u0131n ilk belirtisi olabilir\u201d diye konu\u015ftu. Ta\u015f hastal\u0131\u011f\u0131n\u0131n tedavi y\u00f6ntemlerinden bahseden Dr. Alan, \u201cEri\u015fkin ta\u015f hatal\u0131\u011f\u0131 tedavisinde oldu\u011fu gibi pediatrik ta\u015f hastal\u0131\u011f\u0131 tedavisinde de ilk ad\u0131m s\u0131v\u0131 al\u0131m\u0131n\u0131 artt\u0131rmakt\u0131r. Bunun yan\u0131nda a\u011fr\u0131s\u0131 var ise a\u011fr\u0131s\u0131n\u0131 kesebilecek analjezik ve antispamotik tedavi uygun olur. Hiperkalsi\u00fcri medikal tedavisinde ayn\u0131 zamanda diyetle a\u015f\u0131r\u0131 sodyum, kalsiyum ve protein al\u0131m\u0131n\u0131n azalt\u0131lmas\u0131 gerekmektedir. Dikkat edilmesi gereken en \u00f6nemli nokta, \u00e7ocuklar\u0131n ya\u015fa g\u00f6re almas\u0131 gereken kalsiyum miktar\u0131n\u0131 almas\u0131na izin verilmelidir, a\u015f\u0131r\u0131 alma durumu varsa k\u0131s\u0131tlanmal\u0131d\u0131r. Diyetle hiperkals\u00fcri tedavisi ba\u015far\u0131l\u0131 olunmad\u0131\u011f\u0131nda uygun dozda tiazid grubu idrar s\u00f6kt\u00fcr\u00fcc\u00fc ila\u00e7lar tedaviye eklenebilir\u201c \u015feklinde konu\u015ftu.<\/p>\n
Tedavi y\u00f6ntemleri y\u00fcz g\u00fcld\u00fcr\u00fcyor<\/p>\n
Son olarak ta\u015f hastal\u0131klar\u0131nda yap\u0131lan cerrahi tedavileri anlatan Op. Dr. Cem Alan \u015f\u00f6yle konu\u015ftu: \u201cD\u0131\u015fardan ultrasonik ses dalgalar\u0131 verilerek v\u00fccutta herhangi bir giri\u015fim olu\u015fturmadan yap\u0131lan ve d\u00fc\u015f\u00fck komplikasyon riski olan bu ESWL y\u00f6ntemi; 2 cm alt\u0131nda olan \u00e7ocukluk \u00e7a\u011f\u0131nda b\u00f6brek ta\u015flar\u0131n tedavisinde olduk\u00e7a yayg\u0131n kullan\u0131lmaktad\u0131r. Ultrasonik ses dalgas\u0131 ile ta\u015flar k\u0131r\u0131lrak k\u0131r\u0131lan par\u00e7alar\u0131n idrar yolundan d\u00fc\u015fmesi hedeflenir. Birka\u00e7 seans gerekebilir ve seanslar aras\u0131 2 haftay\u0131 ge\u00e7memesi gerekmektedir. Di\u011fer bir y\u00f6ntem ise \u00fcreterorenoskopidir. Video kamera y\u00f6ntemiyle ince \u00e7apta aletler ile normal idrar yolundan girilerek v\u00fccutta herhangi bir delik a\u00e7\u0131lmadan idrar torbas\u0131nda, b\u00f6brek idrar kanal\u0131nda ve b\u00f6brekteki ta\u015flar lazer, pn\u00f6motik gibi k\u0131r\u0131c\u0131larla k\u00fc\u00e7\u00fck milimetrik boyutlara par\u00e7alanmas\u0131 prensibine dayal\u0131 y\u00f6ntemdir. Perkutan nefrolitotomi y\u00f6ntemi de uzun s\u00fcredir eri\u015fkinlerde yap\u0131lan ve daha ince ve k\u00fc\u00e7\u00fck \u00e7apl\u0131 aletlerin geli\u015ftirlmesi ile birlikte son y\u0131llarda s\u0131kl\u0131kla \u00e7ocuk hastalarda da ba\u015far\u0131l\u0131 bir \u015fekilde yap\u0131lan y\u00f6ntemdir. V\u00fccut yan\u0131nda b\u00f6bre\u011fin d\u0131\u015f\u0131ndan cilde 0.5-1cm\u2019ye yak\u0131n kesi yap\u0131larak \u00e7e\u015fitli aletler ile kapal\u0131 \u015fekilde b\u00f6bre\u011fe kamera sistemi ile girilip pn\u00f6motik, lazer veya ultrasonik k\u0131r\u0131c\u0131lar ile ta\u015flar k\u00fc\u00e7\u00fck par\u00e7alara ayr\u0131l\u0131p k\u0131r\u0131lan par\u00e7alar\u0131n v\u00fccut d\u0131\u015f\u0131na al\u0131nmas\u0131 prensibine dayan\u0131r. A\u00e7\u0131k cerrahi ve laparoskopik cerrahi y\u00f6ntemine ise gereksinim oran\u0131 olduk\u00e7a azalm\u0131\u015ft\u0131r. Ancak ta\u015f operasyonun yan\u0131nda d\u00fczeltilmesi gereken b\u00f6brek kanal darl\u0131\u011f\u0131 gibi anatomik bozukluklar veya ciddi ortopedik patolojiler olan hastalarda a\u00e7\u0131k cerrahi alternatif bir y\u00f6ntemdir.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
MED\u0130CAL PARK KOCAEL\u0130 HASTANES\u0130 KOCAEL\u0130 \u00dcROLOJ\u0130 UZMANI OP. DR. CEM ALAN, PED\u0130ATR\u0130K \u00dcR\u0130NER S\u0130STEM TA\u015e HASTALI\u011eININ \u00d6ZELL\u0130KLE T\u00dcRK\u0130YE, PAK\u0130STAN, BAZI G\u00dcNEY ASYA \u00dcLKELER\u0130 G\u0130B\u0130 ENDEM\u0130K B\u00d6LGELER \u0130LE \u00d6ZELL\u0130KLE DO\u011eU VE G\u00dcNEYDO\u011eU B\u00d6LGES\u0130NDE OLDUK\u00c7A YAYGIN B\u0130R HASTALIK OLDU\u011eUNU S\u00d6YLED\u0130.<\/p>\n","protected":false},"author":1,"featured_media":244565,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[593,7305,1440,13085,5641,6809],"class_list":["post-244564","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","tag-cekti","tag-cocuklarda","tag-dikkat","tag-hastaligina","tag-tas","tag-uzmanlar"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.tvturk.com\/wp-content\/uploads\/2019\/12\/uzmanlar-cocuklarda-tas-hastaligina-dikkat-cekti_453e28e.jpg?fit=1000%2C1000","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/paKIfm-11CA","_links":{"self":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/244564","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/comments?post=244564"}],"version-history":[{"count":0,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/244564\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media\/244565"}],"wp:attachment":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media?parent=244564"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/categories?post=244564"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/tags?post=244564"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}