Mersin’de Tip 1 Aort Diseksiyonunda doku yapıştırıcısı kullanımının kanama üzerine etkisi: Kanama kontrolünün tarihsel kısa analizi

Year 2020, Volume: 10 Issue: 1, 138 - 144, 31.01.2020

Mehmet Erin Tüysüz Ali Gül

https://doi.org/10.31020/mutftd.652438

Abstract

Amaç:
Mersin Şehir Eğitim ve Araştırma Hastanesi’nde Tip 1 aort diseksiyonu nedeniyle acil
operasyona alınan hastalarda doku yapıştırıcısı kullanımının kanama üzerine
etkisini ortaya koymaktır. Kalp cerrahisinde kullanılan kanama durdurucu
yöntemler ve ilaçların tarihsel gelişimini incelemektir.

Yöntem:
Mersin Şehir
Eğitim ve Araştırma Hastanesi kalp ve damar cerrahisi kliniğinde 2014-2019
yılları arasında Tip 1 aort diseksiyonu nedeniyle acil operasyona alınan 40 olgu
geriye dönük olarak incelendi. Çalışmaya ardışık 34 hasta dâhil edildi.
Hastalar ameliyatta doku yapıştırıcısı kullanılıp kullanılmamasına göre iki
gruba ayrıldı. Doku yapıştırıcısı kullanılmayanlar grup 1 (n=20), kullanılanlar
grup 2 (n=14) olarak tanımlandı. Tanımlayıcı analizlerde, kategorik değişkenler
frekans ve yüzdeyle, sayısal değişkenler medyan kullanılarak yapıldı. İkili
grup karşılaştırmalarında kategorik değişkenler için Pearson Ki Kare testi,
sayısal değişkenler için Man Whitney U testi kullanıldı.

Bulgular: Grup 1’deki hastaların
medyan yaşı 63 iken, grup 2’de medyan yaşı 54’tü ( p=0,03). Grup 2’deki
hastalarda hipertansiyon ve postoperatif solunumsal komplikasyonlar daha fazla
görüldü (p=0,03). Toplam mortalite (p=0,03) ve operasyon sırasındaki mortalite
(p=0,02) grup1’de daha yüksekti. Kalp cerrahisi tarihinde kullanılan kanama
önleyici ajanlar ve yöntemlerin aort diseksiyon cerrahisinde de kullanıldığı
görüldü.

Sonuç:
Tip 1 aort
diseksiyonu ameliyatlarında doku yapıştırıcısı kullanımının kanama miktarı,
kanama nedeniyle reoperasyon ve kan tranfüzyon ihtiyacı üzerine etkisi yoktur.

Keywords

Tip 1 aort diseksiyonu, doku yapıştırıcısı

Effect of tissue sealants on bleeding in type 1 aortic dissections in Mersin: short-historical analysis of bleeding control

Abstract

Objective:
To
investigate the effect of tissue sealants on bleeding in patients who have been
taken to emergency operation for type 1 aortic dissection. To investigate the
methods and medications that were used to control bleeding throughout the
history of cardiac surgery.

Methods: All patients who underwent emergency operation
for Type 1 aortic dissection in Mersin City Education and Research Hospital
between 2014 and 2019 were retrospectively evaluated 40 patients. 34
consecutive patients were included to the study. Patients were divided into two
groups. Patients in group 1 (n=20) didn’t receive tissue sealants and patients
in group 2 (n=14) received tissue sealants. In descriptive analyzes,
categorical variables were made by frequency and percentage, numerical
variables were median. In Binary group comparisons Pearson chi-square test was
used for categorical variables and Man Whitney U test was used for numerical
variables.

Results:
Median age
for Group 1 was 63, whereas it was 54 in group 2 (p=0,03). Hypertension and
post operative respiratory complications were more frequent in Group 2 (p=0,03).
Overall mortality and intraoperative mortality was higher in group 1 (p=0,03)
and (p=0,02) respectively. Hemorrhage control agents and techniques that were
used in history of cardiac surgery were also used in aortic dissection
operations.

Conclusion:
Usage of
tissue sealants in Type 1 Aortic dissection operations is ineffective on the
amount of post operative bleeding, reoperation due to bleeding and the need for
blood transfusions.

Keywords

Type 1 aortic dissections, tissue sealants

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