GEBELİKTE AKUT APANDİSİT OLGULARINA YAKLAŞIM; BİR DEVLET HASTANESİ PRATİĞİ

Year 2022, Volume: 29 Issue: 1, 15 - 22, 01.03.2022

Serdar Kırmızı

https://doi.org/10.17343/sdutfd.946856

Abstract

Amaç
Akut apandisit, gebelikte en sık yapılan non-obstetrik
cerrahidir. Gebeliğin kendine özgü fizyolojik, anatomik
değişiklikleri tanı ve tedavi sürecini güçleştirir. Literatürde
bu konuyla ilgili çalışmaların çoğunlukla tersiyer
merkezlerin deneyimlerini yansıttığı görülmektedir. Bu
çalışmanın amacı gebelikte akut apandisit vakalarına
ilişkin ikinci basamak bir hizmet hastanesindeki perioperatif
deneyiminin sunulmasıdır.
Gereç ve Yöntem
Çalışma Ocak 2015- Kasım 2020 tarihleri arasında
ikinci basamak bir devlet hastanesinde retrospektif
olarak yapıldı. Gebelik döneminde akut apandisit tanısı
alan, postoperatif takipleri ve doğumları hastanemizde
gerçekleştirilen hastalar çalışmaya alındı.
Bulgular
Hastaların yaş aralığı 24 yaş (18-35), ortanca gestasyonel
hafta 17 hafta (8-32) idi. Ortanca lökosit sayısı
11,6 x103 uL, nötrofil sayısı 8,6 x103 uL, lenfosit sayısı
2 x103 uL, trombosit sayısı 271 x103 uL, C-reaktif
protein 4,5, nötrofil/lökosit oranı 4,3, trombosit/ lenfosit
oranı 120,8, lökosit/ C-reaktif protein oranı 0,7
olarak saptandı. Spinal anestezi en çok tercih edilen
yöntemdi ve hastaların tamamında açık cerrahinin uygulanmış
olduğu görüldü. Ortanca doğum haftası 38
idi (36-40), sadece bir hastada preterm doğumun geliştiği
saptandı. Ek maternal veya fetal komplikasyon
gelişmediği görüldü.
Sonuç
Multidisipliner yaklaşım koşuluyla ikinci basamak hizmet
hastanelerinde de gebe akut apandisit’li hastalar
başarıyla tedavi edilebilir.

Keywords

Akut apandisit, Appendektomi, Gebelik, Doğum, Devlet hastanesi

AN APPROACH TO ACUTE APPENDICITIS CASES DURING PREGNANCY: A PUBLIC HOSPITAL PRACTICE

Abstract

Objective
Acute appendicitis is the most common non-obstetric
surgery performed during pregnancy. Physiological
and anatomical changes specific to pregnancy
complicate the diagnosis and treatment processes.
It has been seen in the literature that the studies on
this subject mostly reflect the experiences of tertiary
centers. The present study aimed to present the
perioperative experience of acute appendicitis cases
in pregnancy in a secondary care hospital.
Materials and Methods
The present study was carried out retrospectively
between January 2015 and November 2020 in a
secondary state hospital. Patients diagnosed with
acute appendicitis during pregnancy and whose
postoperative follow-ups and labors were carried out
in our hospital were included in the study.
Results
The median age of the patients was 24 years (18-
35), the median gestational week was 17 weeks (8-
32). The median leukocyte count was 11.6 x103 uL,
neutrophil count was 8.6 x103 uL, lymphocyte count
was 2 x103 uL, thrombocyte count was 271 x x103 uL,
C-reaktif protein was 4.5, neutrophil/ leukocyte ratio
was 4.3, thrombocyte/lymphocyte was ratio 120.8,
and the leukocyte /C-reaktif protein ratio was 0.7.
Spinal anesthesia was the most preferred method and
it was observed that open surgery was performed in
all patients. The median week of delivery was 38 (36-
40) and preterm labor was seen in only one patient.
It was observed that no additional maternal or fetal
complications developed.
Conclusion
Pregnant acute appendicitis patients can also be
successfully treated in secondary service hospitals on
the condition of a multidisciplinary approach.

Keywords

Acute appendicitis, Appendectomy, Pregnancy, Labor, State hospital.

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