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Periferik Arter Hastalıklarında Risk Faktörleri ve Klinik Bulgular

Risk Factors and Clinical Findings of Peripheral Arterial Diseases

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Abstract (2. Language): 
Peripheral Arterial Disease (PAD) is a manifestation of systemic atherosclerosis which is associated with an increased risk of death and ischemic events (myocardial infarction, stroke). The aim of this study is to detect the risk factors in PAD and by combining with clinical signs to determine the management strategies for PAD. Four-hundred and forty PAD patients, who were admitted to the Radiology Department of Uludag University, School of Medicine and a Private Angiography center in Bursa were evaluated in regard of the risk factors and clinical findings. Of these patients, 389 were men (89%), 51were women (11%). The main symptom among patient was intermittant claudication (%73.9).The results of peripheral angiographies revealed that the 68 % of the patients had stenosis, 19 % had occlusion, 2 % had aneurysm whereas 11 % were normal. Our study showed that the incidence of PAD is higher in men than women and that smoking is an important risk factor for PAD. Evaluation of patients’ history and the results of the angiography together disclosed that, in general, an early diagnosis could not be made and treatment to eliminate the risk factors were not performed on time. If the primary care physicians were to spent sufficient amount of time for taking the history and performing physical examination, PAD could be detected and treated more promptly. The Physician’s examination is the most cost effective way of all the tests that can be ordered for diagnosis.
Abstract (Original Language): 
Periferik arter hastalığı (PAH), iskemik olaylar (myokard infarktüsü,inme) ve ölüm riskinde artma ile birlikte olan sistemik aterosklerozun belirginleşmesidir. Bu çalışmada periferik arter hastalığının risk faktörlerinin saptanması ve klinik bulgular ile birlikte değerlendirilerek aile hekimliği pratiğinde PAH’na yaklaşım kriterlerinin belirlenmesi amaçlandı. Uludağ Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalı Anjiografi Ünitesi ve Bursa’daki özel bir anjiografi merkezine başvuran 440 vaka, risk faktörleri ve klinik bulgular açısından incelendi. Olguların 389’u erkek (%89), 51’i kadın (%11) idi. Hastalarda en çok yakınılan ilk neden %73.9’unda yürümekle ortaya çıkan ağrı (kladikasyo) idi. Yapılan periferik anjiografi tetkiki sonucunda hastaların %68’inde stenoz, %19’unda oklüzyon, %2’inde anevrizma, %11’inde normal anjiografi ile uyumlu bulgular saptandı. Çalışmamız PAH’nın erkeklerde kadınlardan daha fazla olduğunu ve sigaranın belirgin bir risk faktörü olduğunu göstermiştir. Olguların anamnezleri ve anjiografi sonuçları birlikte değerlendirildiğinde genellikle erken tanı konulamadığı ve risk faktörlerini elimine edebilecek uygulamaların zamanında yapılmadığı ortaya çıkmıştır. Eğer birinci basamak hekimi, anamnez ve muayene için uygun zamanı ayırır ise PAH tanısını ve tedavisini uygun bir şekilde yapabilir. Hekimin muayenesi bilinen diğer testlerin hepsinden daha etkin ve ucuzdur.
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