Bronşektazide Cerrahi Öncesi ve Sonrasında Uygulanan Pulmoner Rehabilitasyon Yöntemleri

Yıl 2019, Cilt: 2 Sayı: 1, 10 - 21, 22.05.2019

Neriman Temel Aksu Abdullah Erdoğan

Öz

Bronşektazi
balgam üretimi ve tekrarlayan enfeksiyonla birlikte havayolunun kalıcı
genişlemesi durumudur. Bronşektazide cerrahi artık çok sık uygulanmamaktadır.
Fakat maksimal ilaç tedavisiyle kontrol altına alınamayan lokalize
bronşektazide cerrahi düşünülmektedir.

Cerrahi
öncesi aktif ve akut enfeksiyon antibiyotiklerle ciddi şekilde tedavi
edilmelidir. Komple bakterial eradikasyon imkansız olmasına rağmen, antibiyotik
tedavinin amaçları balgamın volümünü ve rengini azaltmaktır. Bu yüzden pürülan
ve bol balgamlı hastalarda göğüs fizyoterapisi ve antibiyotikler balgam volümü
minimum olana kadar ve rengi mukoid olana kadar devam edilmelidir. Bu minimum 2
haftayı almaktadır. Daha sonra bu hastalar cerrahi öncesi 2 gün yoğun göğüs
fizyoterapisi ve vibratör masajlı postüral drenaj programına alınmalıdırlar.
Buna postoperatif dönemde de devam edilmelidir. Proflaktik antibiyotiklere de
başlanmalı ve postoperatif 48 saate kadar verilmelidir.

Bronşektazi
cerrahisi sonrası tedavi akciğer rezeksiyonu geçiren hastalarla aynıdır. Erken
mobilizasyon, agresif pulmoner temizlik, göğüs fizyoterapisi ve beslenme
önemlidir. Bronşektazili hastaların egzersiz kapasitesi ve yaşam kalitesi
azalmaktadır.  Pulmoner rehabilitasyon bu
sorunları azaltabilmektedir. 

Bronşektazi
cerrahisi sonrası hastalara, standart akciğer rezeksiyonundan sonra uygulanan
tedavi yöntemleri uygulanmaktadır. Erken mobilizasyon, agresif pulmoner
temizlik, göğüs fizyoterapisi ve beslenme desteği önemli konulardandır.

Operasyon
öncesi ve sonrası uygulanan pulmoner rehabilitasyon programı; egzersiz ve
inspiratuar kas eğitimini, ventilasyonu arttıran teknikleri, hava yolu
temizleme tekniklerini ve hasta eğitimini içermektedir.

Anahtar Kelimeler

Bronşektazi, Cerrahi

Kaynakça

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