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Öğe Hemodiyaliz Kateter Uygulamalarında Hasta Memnuniyetinin Görsel Analog Ölçekle Değerlendirilmesi(2013) Acıpayam, Mehmet; Altınay, Levent; Halıcı, Ümit; Hüseyinov, Serhat; Ketenciler, Serkan; Karaca, Okay Güven; Canbaz, SuatAmaç: Bu çalışmada kateter aracılığıyla hemodiyalize alınan hastalarda kateter uygulanma yerinin hasta memnuniyeti ve günlük yaşamı üzerine olan etkisini araştırdık. Gereç ve Yöntemler: Bu prospektif çalışmaya Ocak 2005-Eylül 2006 tarihleri arasında kliniğimizde hemodiyaliz amaçlı geçici ve kalıcı kateter takılan 171 hasta (104'ü erkek, 67'si kadın, yaş ortalaması 56,3±14,8) alındı. Hastaların hemodiyaliz kateterinden memnuniyeti ağrı, kateter kaynaklı hareketin engellenmesi, tuvalet ihtiyacını giderebilme, duş alma ile ilgili sıkıntı, uyku kalitesi ve estetik rahatsızlık düzeyleri Vizüel Analog Skala (0-10 cm) ile değerlendirildi. Bulgular: Kliniğimizde çoğunlukla sağ internal juguler vene geçici hemodiyaliz kateteri takılması tercih edilmiştir. En fazla şikayet sağ internal juguler vene kateter takılan hastalardan gelmiştir. Anatomik lokalizasyona göre en yüksek görsel analog ölçek skorları, sağ internal juguler ven kateterizasyonu yapılan hastalarda bulunmuştur. Bu hastalarda en fazla rahatsızlığın duş sırasında olduğu görülmüştür (ortalama görsel analog ölçek skoru 8.4 cm). Şikayet türüne göre görsel analog ölçek skorları değerlendirildiğinde ağrı ve duş sırasında rahatsızlık en fazla şikayetçi olunan rahatsızlıklar olmuştur (sırasıyla p=0.000 ve p=0.003). Tüm anatomik kateter lokalizasyonlarında en yüksek görsel analog ölçek skorları duş sırasında rahatsızlıkta olduğu görülmüştür. Sonuç: Subklavian yolla hemodiyaliz kateteri takılması, tromboz vb komplikasyonları nedeniyle daha az sıklıkla tercih edilmesine rağmen çalışmamızda hasta memnuniyeti ve konforunun bu teknikte daha fazla olduğu gözlenmiştir. Tromboz riskini azaltacak, hasta memnuniyeti ve konforunu arttıracak yeni yöntemler ve materyaller üzerinde çalışmalar yapılması gerektiğini düşünmekteyiz.Öğe A RETROSPECTIVE COMPARISON OF EARLY RESULTS OF ISOLATED CORONARY ARTERY BYPASS SURGERY IN YOUNG (<40 YEARS) AND MIDDLE AGED (40-60 YEARS) PATIENTS(Carbone Editore, 2015) Halici, Umit; Acipayam, Mehmet; Uncu, Hasan; Altinay, Levent; Ketenciler, Serkan; Ozsoyler, IbrahimIntroduction: Coronary artery disease is usually seen in middle-aged and older population. Although coronary artery disease in young patients is relatively rare compare to older population, the incidence in young people have been increasing recently. In this retrospective study, we aimed to compare the perioperative characteristics and complications of young aged (<40 years) to midlle aged (40-60 years) patients retrospectively. Materials and methods: A total of 1592 patients who underwent isolated coronary artery bypass grafting operation were included in this retrospective study. Patients were divided into two groups according to age as young aged patients (Group 1; a total of 78 patients; 64 males, 14 females, mean age 36.7 +/- 33 years) and middle-aged patients (Group 2; a total of 1514 patients; 1183 males and 331 females, mean age 51.8+/-5.2 years) and preoperative, intraoperative and postoperative parameters were compared. Results: Smoking rates in Group 1 and low molecular density cholesterol levels in Group 2 were higher but it was not statistically significant. Cardiopulmonary bypass time, cross-clamp time, incidence of reoperation, amount of drainage and number of distal anastomoses were not significantly different between groups. Also development of newly onset atrial fibrillation, use of inotropic agents, intensive care stay time, amount of fresh whole blood used, use of left internal thoracic artery and intraaortic balloon pump seen in groups were not statistically significant. The incidence of delirium and time to discharge were significantly increased in Group 2. Hospital mortality rate of Group 2 was 0.39% (6 patients) whereas there was no hospital mortality in Group 1. Conclusion: The coronary bypass grafting operation can be performed in young aged patients with similar early postoperative results as in middle aged patients group. Thus we think that age has no major effect over the early postoperative results of isolated coronary artery bypass surgery.Öğe A retrospective comparison of early results of isolated coronary artery bypass surgery in young (<40 years) and middle aged (40-60 years) patients(Acta Medica Mediterranea, 2015) Halici, Umit; Acipayam, Mehmet; Uncu, Hasan; Altinay, Levent; Ketenciler, Serkan; Ozsoyler, IbrahimIntroduction: Coronary artery disease is usually seen in middle-aged and older population. Although coronary artery disease in young patients is relatively rare compare to older population, the incidence in young people have been increasing recently. In this retrospective study, we aimed to compare the perioperative characteristics and complications of young aged (<40 years) to midlle aged (40-60 years) patients retrospectively. Materials and methods: A total of 1592 patients who underwent isolated coronary artery bypass grafting operation were included in this retrospective study. Patients were divided into two groups according to age as young aged patients (Group 1; a total of 78 patients; 64 males, 14 females, mean age 36.7±3.3 years) and middle-aged patients (Group 2; a total of 1514 patients; 1183 males and 331 females, mean age 51.8±5.2 years) and preoperative, intraoperative and postoperative parameters were compared. Results: Smoking rates in Group 1 and low molecular density cholesterol levels in Group 2 were higher but it was not statistically significant. Cardiopulmonary bypass time, cross-clamp time, incidence of reoperation, amount of drainage and number of distal anastomoses were not significantly different between groups. Also development of newly onset atrial fibrillation, use of inotropic agents, intensive care stay time, amount of fresh whole blood used, use of left internal thoracic artery and intraaortic balloon pump seen in groups were not statistically significant. The incidence of delirium and time to discharge were significantly increased in Group 2. Hospital mortality rate of Group 2 was 0.39% (6 patients) whereas there was no hospital mortality in Group 1. Conclusion: The coronary bypass grafting operation can be performed in young aged patients with similar early postoperative results as in middle aged patients group. Thus we think that age has no major effect over the early postoperative results of isolated coronary artery bypass surgery.