Assesment of the patients with broncopulmonary dysplasia BPD in terms of somatic growth pulmonary problems and neurodevelopmental features on long term follow up Original Article

Yıl 2008, Cilt: 43 Sayı: 1, 17 - 23, 01.03.2008

Sultan Kavuncuoğlu Esin Yıldız Gök Emel Altuncu Ayfer Arduç Seçil Alpaslan Gülseren Arslan Ender Aksüyek Engin Öztüregen Mehmet Nevzat Çizmeci

Öz

Aim: This study has been performed for the assessment of postneonatal problems growth and neuromotor development of the patients with bronchopulmonary displasia BPD Material and Method: 31 of the 39 live preterms 79 who were born in 2003 2004 period were assessed in July 2006 Patients who were diagnosed as BPD were named Group I The control group was formed as preterms who were born in our hospital after Group I patients who were close to Group I in terms of weight and gestational age and who had no history of mechanical ventilation support and was named as Group II The data of the Group II patients were obtained from the computer database and personal files Both groups were assessed for their somatic growth and neurodevelopmental profiles at 21 42 months Results: 20 patients 64 5 from the Group I had at least one respiratory infection and 6 of them were admitted to the hospital Microcephaly was found in 38 7 of our patients and 35 were diagnosed as somatic growth retardation on growth follow up Denver Developmental Screening Test II was found abnormal in 10 32 preterms and 10 32 patients had deficiency and 3 patients had deficiency plus sequel in modified Amiel Tison Test One patient had total blindness 5 patients 16 from the Group II were on therapy for multiple respiratory infections and one of them was diagnosed as reactive airway disease 10 of the patients had somatic growth retardation 13 had microcephaly when Group II patients were assessed in terms of somatic growth Two patients 6 had abnormal Denver II Test 4 patients 16 had deficiency in Modified Amiel Tison Test but none of them had sequel Conclusions: Presence of BPD is a significant risk factor for disease during the somatic and neurodevelopmental follow up As a result of our study we have seen that patients with BPD when compared to control group were significantly retarded in terms of neurological and somatic growth Immaturity intraventricular haemorrage microcephaly meningitis were important risk factors playing role in the morbidity Turk Arch Ped 2008; 43: 17 23 Key words: BPD neurodevelopmental follow up preterm somatic growth

Anahtar Kelimeler

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Bronkopulmoner displazili hastalarımızın uzun dönem izleminde somatik büyüme akciğer sorunları ve nörogelişimsel özelliklerinin irdelenmesi Orijinal Araştırma

Öz

Amaç: Bu çalışma bronkopulmoner displazi’li BPD hastaların yenidoğan dönemi sonrasındaki sorunları büyüme ve nöromotor gelişmelerini değerlendirmek amacıyla yapıldı Gereç ve Yöntem: 2003 2004 tarihleri arasında doğan ve yaşayan 39 olgudan 31’ine 79 ulaşılarak 2006 yılı Temmuz ayında değerlendirildi Bronkopulmoner displazili hastalara Grup I adı verildi Kontrol grubu ise Grup I’deki her bir hastadan sonra hastanemizde doğan en yakın tartı ve gebelik haftasında olan ve hiç mekanik vantilasyon desteği gerekmeyen erken doğmuş bebeklerden oluşturuldu ve Grup II olarak adlandırıldı Grup II’deki hastalara ait bilgiler veri tabanından ve dosyalarından elde edildi 21 42 ayda her iki grubun somatik büyüme ve nörogelişimsel süresi değerlendirildi Bulgular: Grup I’deki hastaların 20’si 64 5 bir veya daha fazla akciğer enfeksiyonu geçirirken altısı bu nedenle hastaneye yatırıldı Büyüme izleminde hastaların 38 7’sinde mikrosefali 35’inde somatik büyüme geriliği bulundu Nörogelişimsel değerlendirmede Denver Gelişimsel Tarama Testi DGTT II 10 32 erken doğmuş bebekte anormal bulunurken Modifiye Amiel Tison’da 10 32 olguda yetersizlik üç olguda sekel yetersizlik bulundu Bir hastada körlük gelişmişti Grup II’de ise hastaların beşi birden fazla akciğer enfeksiyonu nedeniyle tedavi edilirken hastalardan birine reaktif hava yolu hastalığı tanısı kondu Grup II’deki hastaların somatik büyüme özelliklerine bakıldığında; hastaların 10’unda somatik büyüme geriliği 13’ünde mikrosefali bulundu DGTT II iki 6 erken doğmuş bebekte anormal bulunurken Modifiye Amiel Tison’da 4 16 olguda yetersizlik saptandı ancak hiçbirinde sekel gelişmemişti Çıkarımlar: Literatürde somatik ve nörogelişimsel izlemde BPD’nin varlığı önemli bir hastalık nedeni olarak vurgulanmaktadır Biz BPD’li hastalarımızın kontrol grubuyla karşılaştırıldığında hem somatik hem de nörolojik gelişimde önemli derecede geri kaldıklarını gördük İmmatürite kafa içine kanama mikrosefali menenjit sinir sistemine ait hastalıkları arttıran etmenlerdi Türk Ped Arş 2008; 43: 17 23 Anahtar kelimeler: Bronkopulmoner displazi erken doğmuş bebek nörogelişimsel izlem somatik büyüme

Anahtar Kelimeler

Bronkopulmoner displazi, erken doğmuş bebek, nörogelişimsel izlem, somatik büyüme

Kaynakça

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