Akciğer dekortikasyon ameliyatı yapılan erişkin hastaların preoperatif ve postoperatif olarak arteryel kan gazı,solunum fonksiyon testleri ve akciğer perfüzyon sintigrafilerinin karşılaştırılması
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- Tez No: 242280
- Danışmanlar: DOÇ. DR. ŞEVVAL EREN
- Tez Türü: Tıpta Uzmanlık
- Konular: Göğüs Kalp ve Damar Cerrahisi, Thoracic and Cardiovascular Surgery
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2009
- Dil: Türkçe
- Üniversite: Dicle Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: Göğüs Cerrahisi Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: Belirtilmemiş.
Özet
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Özet (Çeviri)
WESPleural empyema is an infective process with high mortality andmorbidity despite broad-spectrum antibiotics and drainage of infected pleuralcavity.Empyeme is more frequently observed in underdeveloped or developingcountries due to inadequacy of sanitation, substructure and sewer system ormisdiagnosis of disease.Fibrothorax may develop due to pleural peel that would restrictexpansion of lung. Patients with fibrothorax would not response to tubethoracostomy and respiration reduces or annihilates. Decortication isdescribed as removing the peel that restricts lung parenchyme. Our aim is toimprove respiratory functions by decortication of pleural peel subsequent tofibrothorax.Registrations of 37 patients with chronic empyema between January2000 and November 2008 that were followed-up in Chest Surgery Clinics ofMedical School in Dicle University were examined retrospectively. Patientswith preoperative and postoperative respiratory function tests, arteriel bloodgas analysis and lung perfusion scintigraphy were included.Age disturbance was 15?73 years (37,3). 25 patients were male(%67,6), and 12 patients were female (%32,4). Right and left thoracotomywere performed in 15 (%40,5) and 22 (%59,5) patients, respectively. 28patients (%75,6) had chronic fibrinous pleuritis and 9 patients (%24,3) hadtuberculous pleuritis.Postoperative ratios of FEV1% and FVC% were augmented by 24,74%and 24,35%, respectively and results were statistically significant (p?0,001).2Preoperative and postoperative perfusion scintigraphic examination wascarried out. Improvement ratios were 28,1% in right and 32% in left lungperfusion.Preoperative and postoperative blood gas analysis were compared.Postoperatve partial oxygen pressure was increased by 5,17% (p<0,01).Improvement ratio of oxygen saturation was 2,47% (p<0,05).Both wassignificant.In conclusion, respiratory function tests were significantly improvedsubsequent to decortication of patients with chronic pleural empyema. Lungperfusion of effected side were apparently disordered. Improvement wassignificant subsequent to decortication. Both partial oxygen pressure andoxygen saturation that were preoperatively low, significantly improved. Nosignificant improvement obtained in partial carbondioxyte and pH levels(p>0,05).
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