Amaç:
Plevral ampiyem (PA) pnömoninin ciddi bir komplikasyonudur ve önemli bir
problem olmaya devam etmektedir. Farklı tedavi yaklaşımları yayımlanmış birçok
raporda dikkat çekicidir, ancak ideal tedavi için güçlü kanıt sağlamamaktadır.
Bu çalışmada, PA tanısı alan hastalara yaklaşımımızı değerlendirmeyi ve daha
önce yayınlanmış çalışmalarda tam oturmamış tedavi yaklaşımı gölgesinde
merkezimizin deneyimini sunmayı amaçladık.
Gereç ve Yöntemler:
Bu çalışma Ocak 2011-Aralık 2016 tarihleri arasında tek merkezde izlenen 1-17
yaşları arasındaki 48 hastanın değerlendirildiği retrospektif bir çalışmadır.
Hastaların başvuru öncesi durumları,
riskleri ve tedavileri, başvuru sırasındaki klinik ve laboratuvar
bulguları, seçilmiş tedavi yaklaşımları, özellikle fibrinolitik tedavi ve
komplikasyonlar değerlendirilmiştir.
Bulgular:
Tüp torakostomi 43/48 (% 89,6) hastaya uygulandı. Fibrinolitik tedavi ile
tedavi edilen hastaların sayısı 22 (% 45.8) ve ortalama doz toplamda 5,18 ±
2,59 (1-9) idi. Fibrinolitik tedavi PA evre II'de diğer evrelere göre anlamlı
derecede yüksekti (p = 0.001). Yoğun bakım ihtiyacı % 20,8 (n = 10) iken toplam
hastanede kalış süresi 23,58 ± 8,69 (3-47) gündü. Beş hastada (% 10.4) cerrahi
girişim gerekli oldu. Ameliyat ile hastaların fibrinolitik tedavi durumu
arasında anlamlı ilişki bulunmadı. Komplikasyon oranı toplamda % 41.6 idi.
Sonuç:
Çocuklarda PA'da tedavi yaklaşımı standardize edilmemiştir. Sonuç olarak, her
merkez bizim merkezimizde olduğu gibi önceki deneyimleri ve sonuçları göz
önünde bulundurarak kendi tedavi yaklaşımını uygulamayı tercih ediyor gibi
görünmektedir.
Objective: Pleural
empyema (PE) is a serious complication of pneumonia and continues to be an
important problem. Different treatment approaches are remarkable in many reports,
but do not provide strong evidence for ideal treatment. In this study, we aimed
to evaluate our approach to the patients diagnosed as PE, and to demonstrate
the experience of our center in the shadow of the not fully seated treatment approach
in previously published studies.
Material and Methods: This
is a retrospective study of 48 patients aged between 1-17 years from January
2011 to December 2016 in one center. Pre-admission status, risks and treatments
of the patients, clinical and laboratory findings on admission, selected
treatment approaches, especially the fibrinolytic therapy, and complications
were evaluated.
Results: Tube
thoracostomy was performed in 43/48 (89.6%). Patients treated with fibrinolytic
therapy was 22 (45.8%) and the mean dose was 5,18±2,59 (1-9) in total.
Fibrinolytic therapy was significantly higher in PE stage (II) than the other
stages (p = 0.001). Intensive care need was 20.8% (n = 10) while total hospital
stay was 23.58 ± 8.69 (3-47) days. Thoracotomy/decortication or VATS were
required in five (10.4%) patients. There was no significant relationship
between the operation and fibrinolytic treatment status of patients. The
complication rate was 41.6% in total.
Conclussion: The
therapeutic approach to PE in children is not standardized. As a result, each
center seems to prefer to apply its own treatment approach, considering
previous experiences and results, like in our center.
Primary Language | English |
---|---|
Subjects | Internal Diseases |
Journal Section | ORIGINAL ARTICLES |
Authors | |
Publication Date | January 27, 2020 |
Submission Date | February 8, 2019 |
Published in Issue | Year 2020 Volume: 14 Issue: 1 |
The publication language of Turkish Journal of Pediatric Disease is English.
Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 10 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.
The aim of the Turkish Journal of Pediatrics is to publish high-quality original research articles that will contribute to the international literature in the field of general pediatric health and diseases and its sub-branches. It also publishes editorial opinions, letters to the editor, reviews, case reports, book reviews, comments on previously published articles, meeting and conference proceedings, announcements, and biography. In addition to the field of child health and diseases, the journal also includes articles prepared in fields such as surgery, dentistry, public health, nutrition and dietetics, social services, human genetics, basic sciences, psychology, psychiatry, educational sciences, sociology and nursing, provided that they are related to this field. can be published.