Dergiler / Toraks Dergisi / 2005 / Cilt: 6 - Sayı: 2
Postoperatif solunumsal komplikasyonlar
- Dergi
- Toraks Dergisi
- Sayfa
- 104–108
- DOI
- —
Özet
Postoperatif (PO) solunumsal komplikasyonları değerlendirmek amacıyla, Kasım 2002-Haziran 2003 tarihleri arasında cerrahi kliniklerden PO dönemde istenen konsültasyonlar prospektif olarak kaydedildi. On ayrı cerrahi kliniğinde yaş ortalamaları 53±18 (20-102) olan 66’sı kadın (%41.8), 92’si erkek (%58.2) toplam 158 hasta PO dönemde konsülte edildi. En sık PO konsültasyon isteği nedeni, dispne (%31 [49/158]) ve radyolojik bulgulardı (%17.7 [28/158]). Olguların %36.1’inde (57) hipoksemi söz konusuydu. Olguların %38’inde (60) akciğer grafisi normal bulundu. En sık görülen radyolojik anormallik plöreziydi (%17.1 [27/158]). Toplam 28 olguda (%17.7) bilgisayarlı tomografi, 16 olguda (%10.1) ventilasyon-perfüzyon sintigrafisi istendi. Olguların %13.3’ünde (21) normal solunum sistemi bulguları, %64.6’sında (102) PO pulmoner komplikasyonlar tespit edildi. PO en sık görülen solunumsal komplikasyonlar %20.6 (21/102) diyafragmatik disfonksiyon, %18.6 (19) kronik obstrüktif akciğer hastalığında kötüleşme (bronkospazm), %17.6 (18) atelektazi, %14.7 (15) pnömoniydi. Üst batın ve toraks cerrahilerinden sonra PO uzamış mekanik ventilasyon ve plevral efüzyon, alt batın ve diğer cerrahilerdekine göre anlamlı olarak yüksek bulundu (p<0.05).
Abstract
The aim of this study was to evaluate postoperative pulmonary complications of patients undergoing operations in 10 different surgery clinics between November 2002 and June 2003. A total of 158 patients, 66 (41.8%) females and 92 males (58.2%), whose mean age was 53±18 (20-102) were included in the study. The study was mainly based on the postoperative consultations requested by these clinics. The most common causes of consultation requests were dyspnea (31% [49/158]) and abnormal radiological findings (17.7% [28/158]). Hypoxemia was detected in 36.1% (57) of the patients. Chest X rays of 38% (60) of patients were found as normal. Pleural effusion was the most common radiological abnormality (17.1% [27/158]). Thoracic computed tomography was performed in 28 (17.7%) patients, ventilation perfusion lung scan was performed in 16 (10.1%) patients. Respiratory system examination was normal in 13.3% (21) of patients while postoperative pulmonary complications were detected in 64.6% (102) of patients. The most common respiratory complications observed postoperatively were diaphragmatic dysfunction 20.6% (21/102), worsening of obstructive lung disease (bronchospasm) 18.6% (19), atelectasis 17.6% (18) and pneumonia 14.7% (15) respectively. Upper abdominal and thoracic surgeries had significantly higher rates of prolonged mechanical ventilation and pleural effusion complications than other surgeries (p<0.05).