Spinal ateşli silah yaralanmalarının retrospektif analizi
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Tarih
2020
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Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada 2011 ile 2019 tarihleri arasında Mustafa Kemal Üniversitesi (Hatay-Türkiye), Tayfur Ata Sökmen Tıp Fakültesi Beyin ve Sinir Cerrahisi Anabilim Dalına başvuran spinal ateşli silah yaralanmalı 90 olgunun verileri retrospektif olarak değerlendirildi. Olgular klinik olarak komplet ve inkomplet yaralanmalı olmak üzere iki gruba ayrıldı. Gruplar başvurudaki yaş, cinsiyet, travma oluş mekanizması (Gülhane Askeri Tıp Akademisi Ateşli Silah Yaralanması Ölçeğine göre), nörolojik defisit tipleri, klinik olarak ASIA-ISNCSCI (Amerikan Spinal Kord Yaralanması Birliği- Spinal kord yaralanmasının nörolojik sınıflandırmasına ilişkin uluslararası standartlar) hasar skalası, başvuru anındaki GKS (Glasgow Koma Skalası) aldıkları tedavi şekli (cerrahi, konservatif), gelişen komplikasyonlar ve mortalite oranları açısından karşılaştırıldı. Amaç: Bu çalışmanın amacı, 2011-2019 yılları arasında spinal ateşli silah yaralanması nedeniyle Mustafa Kemal Üniversitesi (Hatay-Türkiye), Tayfur Ata Sökmen Tıp Fakültesi Beyin ve Sinir Cerrahisi Anabilim Dalına başvuran hastaların cerrahi ve konservatif tedavisi sonrası nörolojik iyileşme, mortalite oranları ve tedavi yaklaşımları konusunda elde edilen bilgileri analiz etmektir. Materyal ve Metot: Hastaların verileri hastane arşivinden elde edildi. Hastalarla ilgili tüm veriler önceden hazırlanmış çalışma formlarına kaydedilmiş ve SPSS 22.0 (Sosyal Bilimler İstatistik Paketi) programı kullanılarak analiz edilmiştir. Tablolar arası karşılaştırmada ki-kare testi kullanıldı. Hastalarla ilgili verilerin dağılımında Mann Whitney U testi kullanıldı. İstatistiksel analizler sonucunda elde edilen p <0.05 değerleri anlamlı kabul edildi. Bulgular: Hastaların muayene ve radyolojik görünüm ve değerlendirilmesi sonrasında spinal instabilete bulguları mevcut olan hastalarda cerrahi tedaviye karar verilmiştir. Komplet ve inkomplet yaralanmalarda cerrahi tedavi kararı daha fazla alınmıştır. Normal ASIA (grade E) yaralanmalarda genellikle konversatif tedavi tercih edilmiştir. Sonuç: Bu çalışmadaki veriler eşliğinde spinal ateşli silah yaralanma olgularında, cerrahi tedavinin konservatif tedaviyle karşılaştırıldığında komplet yaralanması olan hastaların nörolojik defisitlerinde bir düzelme olmasa bile oluşabilecek komplikasyonları önlenmeye yardımcı olduğu ve hastanın surveyine olumlu katkısının bulunduğu tespit edilmiştir. İnkomplet yaralanmalı hastaların cerrahi tedaviden konservatif tedaviye oranla nispeten daha fazla yarar gördüğü saptanmıştır.
In this study, the data of 90 cases with firearm spinal injuries that applied between 2011 and 2019 to the Department of Neurosurgery, Tayfur Ata Sökmen Faculty of Medicine in Mustafa Kemal University (Hatay/Turkey) were analyzed by using retrospective analysis. The cases were clinically divided into two groups as complete and incomplete injuries. The groups were compared according to age, gender, trauma formation mechanism (according to Gülhane Military Medical Academy Firearm Injury Scale), neurological deficit types, clinically ASIA-ISNCSCI (American Spinal Cord Injury Association- International standards regarding the neurological classification of spinal cord injury), application GCS (Glasgow coma scale) at the time of treatment (surgical, conservative) developing complications and mortality rates at the application. Objective: The aim of this study is to analyze the information obtained after surgery and conservative treatment of neurological recovery and mortality rates and treatment approaches due to spinal firearm injuries between the years 2011-2019 that patient application to Department of Neurosurgery Department, Tayfur Ata Sökmen Faculty of Medicine in Mustafa Kemal University (Hatay, Turkey). Material and Method: The data of the patients were obtained from the hospital archive. All data related to the patients were recorded in pre-prepared study forms and analyzed by using SPSS 22.0 (Social Sciences Statistics Package) program. Chi-square test was used for comparison between the groups. Mann Whitney U test was used in the distribution of data about the patients. P <0.05 values obtained as a result of statistical analyzes were considered significant. Results: After the examination and radiological appearance and evaluation of the patients, the surgical treatment was decided in patients with spinal instability findings. Surgical treatment decision was taken more in complete and incomplete injuries. In regular ASIA (grade E) injuries, conventional treatment was generally preferred. Conclusion: Based on the data in this study, it was determined that in the firearm spinal injury patients, the surgical treatment helps prevent complications that may occur even if there is no improvement in the neurological deficits of patients with complete injuries compared to conservative treatment and has a positive contribution to the patient's survey. It was determined that patients with incomplete injury benefit from surgical treatment relatively more than conservative treatment. Key words: Firearm spinal injury, Complete injury, Incomplete injury,Firearm
In this study, the data of 90 cases with firearm spinal injuries that applied between 2011 and 2019 to the Department of Neurosurgery, Tayfur Ata Sökmen Faculty of Medicine in Mustafa Kemal University (Hatay/Turkey) were analyzed by using retrospective analysis. The cases were clinically divided into two groups as complete and incomplete injuries. The groups were compared according to age, gender, trauma formation mechanism (according to Gülhane Military Medical Academy Firearm Injury Scale), neurological deficit types, clinically ASIA-ISNCSCI (American Spinal Cord Injury Association- International standards regarding the neurological classification of spinal cord injury), application GCS (Glasgow coma scale) at the time of treatment (surgical, conservative) developing complications and mortality rates at the application. Objective: The aim of this study is to analyze the information obtained after surgery and conservative treatment of neurological recovery and mortality rates and treatment approaches due to spinal firearm injuries between the years 2011-2019 that patient application to Department of Neurosurgery Department, Tayfur Ata Sökmen Faculty of Medicine in Mustafa Kemal University (Hatay, Turkey). Material and Method: The data of the patients were obtained from the hospital archive. All data related to the patients were recorded in pre-prepared study forms and analyzed by using SPSS 22.0 (Social Sciences Statistics Package) program. Chi-square test was used for comparison between the groups. Mann Whitney U test was used in the distribution of data about the patients. P <0.05 values obtained as a result of statistical analyzes were considered significant. Results: After the examination and radiological appearance and evaluation of the patients, the surgical treatment was decided in patients with spinal instability findings. Surgical treatment decision was taken more in complete and incomplete injuries. In regular ASIA (grade E) injuries, conventional treatment was generally preferred. Conclusion: Based on the data in this study, it was determined that in the firearm spinal injury patients, the surgical treatment helps prevent complications that may occur even if there is no improvement in the neurological deficits of patients with complete injuries compared to conservative treatment and has a positive contribution to the patient's survey. It was determined that patients with incomplete injury benefit from surgical treatment relatively more than conservative treatment. Key words: Firearm spinal injury, Complete injury, Incomplete injury,Firearm
Açıklama
Anahtar Kelimeler
Nöroşirürji, Neurosurgery, Spinal ateşli silah yaralanması, Komplet yaralanma İnkomplet yaralanma, Ateşli silah.
