RADYOAKTİF SİNOVEKTOMİNİN NONHEMOFİLİK SİNOVİTLERDE HASTA MEMNUNİYETİ ÜZERİNE ETKİSİ

Yıl 2017, Cilt: 80 Sayı: 1, 13 - 19, 31.03.2017

Elcil Kaya Biçer , Semih Aydoğdu , Hakkı Sur

https://doi.org/10.18017/iuitfd.309198

Öz

Amaç: Radyoaktif sinovektomi (RAS) uygulanmış hemofili dışı sinovit
hastalarında memnuniyet düzeyinin ve bunu etkileyen etmenlerin
değerlendirilmesi

Gereç ve Yöntem: 2002-2013 arasında RAS uygulanmış hemofili dışı
sinovit hastalarından ulaşılabilen ve telefon anketine katılmayı kabul eden 21
hasta çalışmaya dahil edildi. Hastaların 16’sında romatizmal hastalık vardı; 21
hastanın 25’i diz, ikisi dirsek ve üçü ayak bileği eklemi olmak üzere 30
eklemine 41 enjeksiyon yapılmıştı. Yirmi altı ekleme cerrahi sinovektomi
yapılmıştı. Telefon anketinde temel yakınma, her enjeksiyon için hastanın
yararlanım algısı, şişlikte gerileme ya da tekrarlama ve memnuniyetleri
sorgulandı. Ağrı ve işlevsellik için telefonla diz değerlendirme formu
dolduruldu.

Bulgular: Temel yakınma eklemlerin 23 tanesinde (%76,7)
şişlikti. Birinci enjeksiyon 14 eklemde (%46,7) yararlı, dört eklemde (%13,3)
kısmen yararlı, 12 eklemdeyse (%40) faydasız olarak değerlendirildi. On dokuz
eklemde (%63,3) şişlik tamamen, üç eklemde (%10) kısmen geriledi; 10 eklemdeyse
(%33,3) tekrarladı. Hastalar, eklemlerin 20’sinin (%66,7) klinik sonucundan
memnundu. Dizin ağrı ve işlev skorlarının medyan değeri 80’di; iki skor
bakımından memnun olan ve olmayanlar arasında anlamlı fark saptanmadı. Spesifik
bir romatizmal hastalığı olmayanlarda ağrı skoru anlamlı olarak daha iyi
bulundu (p=0.031); bu hastalar uygulanan girişimden daha memnundu (p=0.045).
Şişliğin devam etmesi, tekrarlaması ve yürüme güçlüğü olması hasta
memnuniyetini olumsuz etkileyen etmenler olarak değerlendirildi.

Sonuç: Romatizmal hastalığı olmayanlarda memnuniyet oranının daha yüksek
olması, sistemik hastalığı olanlarda uzun süreli tatminkar sonuç elde
edebilmenin zorluğuyla ilişkili görünmektedir. Memnuniyet üzerinde en etkili
faktör şişliktir. Yüksek nüks riski varlığında ve çok sayıda cerrahi girişimden
kaçınmak için RAS uygun bir seçenektir.

Anahtar
Sözcükler: Radyoaktif
sinovektomi; sinovit; hasta memnuniyeti.

Anahtar Kelimeler

Radyoaktif sinovektomi, sinovit, hasta memnuniyeti

PATIENT SATISFACTION FOLLOWING RADIOACTIVE SYNOVECTOMY IN NONHEMOPHILIC SYNOVITIS

Öz

Objective: To evaluate satisfaction rates of nonhemophilic
synovitis patients who underwent radioactive synovectomy (RAS), to outline the
factors influencing patient satisfaction.

Material and Methods: RAS was performed to 31 nonhemophilic patients
between 2002 and 2013; 21 patients were reached and agreed to make an interview
on the phone. Twenty five of 30 joints were knee, two were elbow, and three
were ankle; 41 injections were performed. Twenty six joints had surgical synovectomy.
Primary complaints before and after RAS, patients’ perception of benefits,
subsidence and recurrence of swelling and patient satisfaction were questioned.
An over the phone knee evaluation form was filled which scored pain and
functionality.

Results: Swelling was the primary complaint in 23 joints
(76.7%). First RAS injection was beneficial for 14 joints (46.7%), partially
beneficial for four (13.3%), and not beneficial for 12 (40%). Swelling subsided
completely in 19 joints (63.3%), partially in three (10%); recurred in 10
joints (33.3%). Satisfaction rate was 66.7%. Median values for pain and
function scores were both 80. The ones without a specific rheumatic disease had
significantly better pain scores (p=0.031), and were more satisfied with the procedure
(p=0.045). Patient satisfaction was influenced by persistence and recurrence of
swelling and restriction of walking.

Conclusion: Satisfaction rate of patients without a rheumatic
disease was significantly higher. In case of systemic diseases, obtaining
durable successful outcomes is more challenging. Swelling was the most
influential factor on satisfaction. In cases of high recurrence risk, RAS is an
alternative to avoid multiple operations.

Key words: Radioactive synovectomy; synovitis; patient satisfaction.

Anahtar Kelimeler

Radioactive synovectomy, synovitis, patient satisfaction

Kaynakça

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