TY  - JOUR
T1  - YENİDOĞANDA PNÖMOTORAKS VE GÖĞÜS TÜPÜ İLE DRENAJ TEDAVİSİ GEREKSİNİMİNE GÖRE DEMOGRAFİK VE KLİNİK ÖZELLİKLERİN KARŞILAŞTIRILMASI
TT  - PNEUMOTHORAX IN NEWBORN AND COMPARISON OF DEMOGRAPHIC AND CLINICAL FEATURES ACCORDING TO DRAINAGE TREATMENT REQUIREMENT WITH CHEST TUBE
AU  - Büyüktiryaki, Mehmet
AU  - Alyamaç Dizdar, Evrim
AU  - Okur, Nilüfer
AU  - Özer Bekmez, Buse
AU  - Tayman, Cüneyt
PY  - 2019
DA  - March
DO  - 10.12956/tchd.510587
JF  - Türkiye Çocuk Hastalıkları Dergisi
JO  - Türkiye Çocuk Hast Derg
PB  - T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi
WT  - DergiPark
SN  - 1307-4490
SP  - 50
EP  - 56
VL  - 13
IS  - 2
LA  - tr
AB  - Amaç: Özellikle prematürebebeklerde önemli bir morbidite ve mortalite nedeni olan pnömotoraks, çocuklukçağında en sık yenidoğan döneminde görülür. Amacımız, ünitemizde pnömotoraks tanısıkonulan yenidoğanların değerlendirilmesidir.Gereç ve Yöntemler: Zekai Tahir Burak Kadın Sağlığı Eğitim ve AraştırmaHastanesi Yenidoğan Yoğun Bakım ünitesinde 1 Ocak 2015 ile 31 Aralık 2015tarihleri arasında pnömotoraks tanısı alarak izlenen yenidoğan bebeklerinkayıtları geriye dönük olarak incelenmiştir. Radyolojik olarak pnömotorakstanısı doğrulanan yenidoğan bebekler çalışmaya dahil edildi. Majör konjenitalanomalisi olanlar ise çalışma dışı bırakıldı.Bulgular: Pnömotoraks insidansı,tüm canlı doğumlar içerisinde %0.37, yenidoğan yoğunba­kım ünitesinde takibi yapılanlar arasında ise %2.6 olarak saptandı. Bebeklerinortalama gestasyon yaşı 34.2±3.6 hafta ve doğumağırlığı 2322±841 gr idi. Pnömotoraks saptanan 67yenidoğanın 49’u erkek (%73.1) idi ve 59’unun (%88.1)sezaryen ile doğduğu saptandı. Pnömotoraksgelişen bebeklerde alttan yatan en sık primer akciğer hastalıklarının TTN(%38.8) ve RDS (%31.3) olduğu belirlendi. Pnömotoraks tedavisi için göğüs tüpüile 50 (%74.7) bebeğe drenaj tedavisi uygulanırken, 17 (%25.3) bebeğin göğüstüpü gereksinimi olmadı. Drenaj gereken grupta gestasyon yaşı ve doğum ağırlığıanlamlı olarak düşük bulundu (p<0.05). Drenaj gereken grupta MV ve NİVsüreleri anlamlı olarak uzun iken, serbest oksijen gereksinimi de daha uzunolmakla birlikte anlamlı fark saptanmadı. Preterm morbiditeleri ve mortaliteaçısından iki grup arasında fark saptanmadı.Sonuç: Yenidoğan döneminde pnömotoraks ile sık olarak ve genellikleilk iki gün içerisinde karşılaşılır. Prematüre bebeklerde en sık altta yatanakciğer hastalığı RDS iken, term bebeklerde TTN’ dir. Pömotoraks gelişenyenidoğanların yaklaşık ¾’üne göğüs tüpü takılarak drenaj tedavisi gerekir.Gestasyon yaşı <32 hafta olan bebeklerde pnömotoraks gelişmesi durumundaneredeyse tamamına göğüs tüpü takılması gerekmektedir. Drenaj gereken bebeklerdeinvaziv ve noninvaziv solunum destek süreleri ile hastanede kalış zamanıbelirgin olarak uzamaktadır.
KW  - Pnömotoraks
KW  - insidans
KW  - drenaj
N2  - Objective: Pneumothorax,which is an important cause of morbidity and mortality especially in prematureinfants, is the most common neonatal period in childhood. Our aim is toevaluate newborns diagnosed as pneumothorax in our unit.Material and Methods: Therecords of newborn babies who were diagnosed as pneumothorax in the NeonatalIntensive Care Unit of Zekai Tahir Burak Women's Health Education and ResearchHospital between January 1, 2015 and December 31, 2015 were analyzedretrospectively. Newborn infants who were diagnosed radiologically aspneumothorax were included in the study. Major congenital anomalies wereexcluded from the study.Results: The incidence ofpneumothorax was 0.37% in all live births and 2.6% in the neonatal intensivecare unit. The mean gestation age of the babies was 34.2 ± 3.6 weeks and birthweight was 2322 ± 841 gr. Of the 67 newborns with pneumothorax, 49 were male(73.1%), and 59 (88.1%) were born by cesarean section. TTN (38.8%) and RDS(31.3%) were the most common underlying pulmonary diseases in infants whodeveloped pneumothorax. For the treatment of pneumothorax, 50 (74.7%) babieswere treated with chest tube and 17 (25.3%) had no chest tube. Gestational ageand birth weight were significantly lower in the drainage group (p <0.05).The duration of MV and NDA was significantly longer in the drainage group, butthe free oxygen requirement was longer, but there was no significantdifference. There was no difference between the two groups in terms of pretermmorbidity and mortality.Conclusion: Inneonatal period, pneumothorax is frequently encountered and usually within thefirst two days. The most common underlying lung disease in premature infants isRDS, while term infants is TTN. About ¾ of newborns developing pneumothoraxshould be treated by inserting a chest tube. In case of pneumothorax developmentin infants with gestational age <32 weeks, a chest tube should be insertedin almost all of them. In infants who need drainage, the duration of invasiveand noninvasive respiratory support and the time of hospitalization aresignificantly longer.
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UR  - https://doi.org/10.12956/tchd.510587
L1  - https://dergipark.org.tr/en/download/article-file/679096
ER  -