MARMARA ÜNİVERSİTESİ HASTANESİNE VARİS DIŞI ÜST GASTROİNTESTİNAL KANAMA İLE BAŞVURAN HASTALARIN DEĞERLENDİRİLMESİ

Abstract

Amaç: Endoskopik tedavi çağında, varis dışı üst gastrointestinal kanama hala önemli bir mortalite ve morbidite nedenidir. Bu çalışmanın amacı, bir eğitim hastanesine varis dışı üst gastrointestinal kanamayla başvuran hastaları klinik ve endoskopik özellikleri açısından araştırmaktır. Metod: Varis dışı üst gastrointestinal kanamayla 1996-2001 tarihleri arasında başvuran 250 hasta retrospektif olarak incelendi. Bulgular: Hastaların ortalama yaşı 59 olup %34.4'ü kadındı. Hastaların %59.6'sında aspirin/non-steroidal anti-inflamatuar ilaç (NSAİİ), %2.8'inde steroid ve %9.6'sınde varfarin kullanımı vardı. Vakaların %31.8'i daha önce de gastrointestinal sistem kanaması geçirmişti. En sık görülen lezyon peptik ülserdi (%49.2), bunu duodenal ve gastrik erozyonlar (%19.2) ile mide tümörleri (%10.8) izliyordu. Lezyonlar mide (%40), duodenum (%33.6), gastrojejunal bileşke (%4.4) ve özofagus (%4.4) yerleşimliydi. H. pylori varlığı 48 olguda araştırıldı, bunların %79.2'sinde pozitif bulundu. Aktif kanama belirtisi olan 33 hastaya endoskopik tedavi uygulandı. Endoskopik tedavisi başarısız olan 3 hastayla beraber 7 hastaya (%2.8) cerrahi işlem uygulandı. Hastaların 6'sı (%2.4) kaybedildi. Sonuç: Çalışmamızda en önemli kanama nedeni peptik ülserdi. Hastaların büyük bir çoğunluğunda kanamaya neden olacak en az bir risk faktörü vardı (H. pilori veya ilaç kullanımı). Kanama nedenleri kolay tedavi edilebildiğinden, hasta grubumuzda endoskopik ve cerrahi tedavi oranı ile mortalite düşük bulundu.

Anahtar Kelimeler: NSAİİ, aspirin, endoskopik tedavi, morbidite ve mortalite

Keywords

• NSAİİ, aspirin, endoskopik tedavi, morbidite ve mortalite

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