Pleural empyema and fibrinolytic therapy in children: A single center experience

Amac: Plevral ampiyem (PA) pnomoninin ciddi bir komplikasyonudur ve onemli bir problem olmaya devam etmektedir. Farkli tedavi yaklasimlari yayimlanmis bircok raporda dikkat cekicidir, ancak ideal tedavi icin guclu kanit saglamamaktadir. Bu calismada, PA tanisi alan hastalara yaklasimimizi degerlendirmeyi ve daha once yayinlanmis calismalarda tam oturmamis tedavi yaklasimi golgesinde merkezimizin deneyimini sunmayi amacladik. Gerec ve Yontemler: Bu calisma Ocak 2011-Aralik 2016 tarihleri arasinda tek merkezde izlenen 1-17 yaslari arasindaki 48 hastanin degerlendirildigi retrospektif bir calismadir. Hastalarin basvuru oncesi durumlari,  riskleri ve tedavileri, basvuru sirasindaki klinik ve laboratuvar bulgulari, secilmis tedavi yaklasimlari, ozellikle fibrinolitik tedavi ve komplikasyonlar degerlendirilmistir. Bulgular: Tup torakostomi 43/48 (% 89,6) hastaya uygulandi. Fibrinolitik tedavi ile tedavi edilen hastalarin sayisi 22 (% 45.8) ve ortalama doz toplamda 5,18 ± 2,59 (1-9) idi. Fibrinolitik tedavi PA evre II'de diger evrelere gore anlamli derecede yuksekti (p = 0.001). Yogun bakim ihtiyaci % 20,8 (n = 10) iken toplam hastanede kalis suresi 23,58 ± 8,69 (3-47) gundu. Bes hastada (% 10.4) cerrahi girisim gerekli oldu. Ameliyat ile hastalarin fibrinolitik tedavi durumu arasinda anlamli iliski bulunmadi. Komplikasyon orani toplamda % 41.6 idi. Sonuc: Cocuklarda PA'da tedavi yaklasimi standardize edilmemistir. Sonuc olarak, her merkez bizim merkezimizde oldugu gibi onceki deneyimleri ve sonuclari goz onunde bulundurarak kendi tedavi yaklasimini uygulamayi tercih ediyor gibi gorunmektedir.

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