Aort diseksiyonu: Bir üniversite hastanesi acil servisine başvuran hastalarda iki yıllık klinik deneyim
[ N/A ]
Tarih
2005
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Aort diseksiyonu hızlı tanı ve tedavi gerektiren mortalitesi yüksek kardiyovasküler bir hastalıktır. Acil serviste doğru ve erken tanı konulması ile uygun tedavinin yapılması prognoz açısından oldukça önemlidir. Ancak geliş şikayetlerinin nonspesifik olması nedeniyle tanıdaki en önemli unsur aort diseksiyonunun akla getirilmesidir. Gereç ve Yöntem: Bu çalışmada, Çukurova Üniversitesi Tıp Fakültesi Acil Tıp Anabilim Dalına Mart 2001 ile Mart 2003 tarihleri arasında başvuran ve aort diseksiyonu tanısı konulan 22 hasta geriye dönük olarak değerlendirildi. De Bakey sınıflandırması kullanılarak hastalar 3 gruba ayrıldı. Bulgular: Çalışmaya 4'ü kadın, 18'i erkek toplam 22 hasta alındı. Ortalama yaşları ise 57.5±8.3 yıldı. Hastaların 10'unda (%45.5) Tip 1, 4'ünde (%18.2) Tip 2, 8'inde (%36.4) Tip 3 diseksiyon saptandı. Tip 1 di-seksiyon olan hastaların %70'inde göğüs ağrısı mevcut iken, karın ağrısı şikayeti olan hastaların tümü tip 3 diseksiyon tanısı aldı. Disekan aort anevrizma tanısı konulan bu 22 hastanın 7'si operasyonu kabul etmedi. Tip 3 diseksiyona sahip hastaların 2'sine yapılan tetkikler sonrasında medikal tedavi önerildi. Cerrahi işlem uygulanan hastalardan 2'si preoperatif, 1 'i perioperatif ve 2'si postoperatif ex oldu. Cerrahi uygulanan 13 hastadan sadece 4'ü başarılı bir operasyon sonrası taburcu edildi. Sonuç: Sonuç olarak ülkemizde aort diseksiyonu halen mortalitesi yüksek bir hastalıktır. Bu hastalara acil serviste erken tanı koyulmalı ve en kısa sürede tedavilerine başlanmalıdır..
Introduction: Aortic dissection is a cardiovascular disease with high mortality requiring quick diagnosis and treatment. Not only accurate but also early diagnosis and treatment in the emergency department is important because of the poor prognosis. Because of nonspecific complaints of the patients on admis­sion, the most important factor in diagnosing aortic dissection is to remind it as a differential diagnosis. Material and Method: In this study, 22 patients diagnosed with aortic dissection in the emergency de­partment during March I, 2001 and March 31, 2003 were evaluated. Patients were divided into three groups by using the De Bakey classification. Results: Twenty two patients (18 females, 4 females; mean age: 57.5±8.3 years) were included into the study. Ten of the patients had type one (45.5%), four of them had type 2 (18.2%), 8 of the patients had type 3 (36.4%) aortic dissection. Chest pain was the most complaint (70%) in patients with type 1 dissec­tion. However, in all of the patients with type 3 dissection, the complaint was the abdominal pain. Seven of the 22 patients did not accept to undergo an operation. Two of the patients with type 3 dissection were treated as medically. Two patients died during the preoperative period, 1 patient died during the operation and two patients were died during the postoperative period. Four patients were discharged af­ter a successful operation. Conclusion: As a result, aortic dissection is still a high-mortality illness. These patients should not only be evaluated and diagnosed quickly but also treated as soon as possible.
Introduction: Aortic dissection is a cardiovascular disease with high mortality requiring quick diagnosis and treatment. Not only accurate but also early diagnosis and treatment in the emergency department is important because of the poor prognosis. Because of nonspecific complaints of the patients on admis­sion, the most important factor in diagnosing aortic dissection is to remind it as a differential diagnosis. Material and Method: In this study, 22 patients diagnosed with aortic dissection in the emergency de­partment during March I, 2001 and March 31, 2003 were evaluated. Patients were divided into three groups by using the De Bakey classification. Results: Twenty two patients (18 females, 4 females; mean age: 57.5±8.3 years) were included into the study. Ten of the patients had type one (45.5%), four of them had type 2 (18.2%), 8 of the patients had type 3 (36.4%) aortic dissection. Chest pain was the most complaint (70%) in patients with type 1 dissec­tion. However, in all of the patients with type 3 dissection, the complaint was the abdominal pain. Seven of the 22 patients did not accept to undergo an operation. Two of the patients with type 3 dissection were treated as medically. Two patients died during the preoperative period, 1 patient died during the operation and two patients were died during the postoperative period. Four patients were discharged af­ter a successful operation. Conclusion: As a result, aortic dissection is still a high-mortality illness. These patients should not only be evaluated and diagnosed quickly but also treated as soon as possible.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Türkiye Acil Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
5
Sayı
1
