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Kardiyovasküler Cerrahide Trombositopeni

Thrombocytopenia In Cardivoascular Surgery

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2008

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Objective: We aimed to evaluate the etiology and frequency of thrombocytopenia in postoperative cardiovascular surgery patients and the complications secondary to thrombocytopenia in this patient group. Material and Methods: We retrospectively reviewed the postoperative data of 167 patients followed and treated at the cardiovascular surgery intensive care unit. The presence of thrombocytopenia was detected from blood count results in patients’ files. Etiologic factors and complications were assessed in patients possessing thrombocytopenia. Results: A thrombocyte level lower than 150,000/mm3 was accepted as thrombocytopenia. It was detected in 64 patients (%38.32). Etiologies for thrombocytopenia were the usage of low molecular weight heparin, disseminated intravascular coagulation, sepsis and septicemia, drugs other than heparin, and systemic diseases. Among these, low molecular weight heparin was the most common reason (n=34, %53.1) and in that particular patient group thrombocyte levels were higher when compared with the other factors (74.842 ± 14.246/mm3, p<0.05, r=0.168). Bleeding complications occurred secondary to thrombocytopenia and the most common hemorrhage sites were from upper gastrointestinal tract (n=12) and mucosal bleeding (n=7). Additionally, presence of diabetes mellitus significantly increased the possibility of thrombocytopenia (r=0.108, p<0.05).Conclusion: Thrombocytopenia is an important factor for mortality and morbidity for patients treated at the cardiovascular surgery intensive care unit. These patients frequently receive anticoagulant therapy in the postoperative period; thus perioperative hemostasis and postoperative close follow up of the blood parameters of these patients are critically important.
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Abstract (Original Language): 
Amaç: Çalışmamızda postoperatif kardiyovasküler cerrahi hastalarında trombositopeni sıklık ve etiyolojik dağılımının belirlenmesi ve trombositopeni komplikasyonlarının irdelenmesi amaçlanmıştır. Yöntem ve Gereçler: Kardiyovasküler cerrahi yoğun bakım ünitesinde postoperatif olarak takip ve tedavisi yapılan toplam 167 hasta retrospektif olarak incelendi. Hastaların dosyalarındaki verilerle; trombositopeni varlığı, trombositopeni saptanan olgularda ise etiyolojik nedenler ve gelişen komplikasyonlar belirlendi. Bulgular: Trombosit sayısı 150,000/mm3 altındaki değerler trombositopeni olarak kabul edildi. Toplam 64 hastada (%38.32) trombositopeni tespit edildi. Trombositopeni nedenleri olarak düşük molekül ağırlıklı heparin kullanımı, yaygın damar içi koagülasyon (DİK), sepsis ve septisemi, heparin dışı diğer ilaçlar ve sistemik hastalıklar tespit edildi. Bu nedenler içinde düşük molekül ağırlıklı heparin kullanımı (n=34, %53.1) en sık rastlanılan faktördü. Ayrıca bu hastalardaki ortalama trombosit sayısı diğer nedenli trombositopenilerdeki trombosit değerleri ile karşılaştırıldığında nispeten daha yüksek seviyelerde olduğu (74.842 ± 14.246/mm3, p<0.05, r=0.168) görüldü. Trombositopeniye bağlı komplikasyon olarak kanama problemleri ile karşılaşıldı ve en sık üst gastrointestinal sistem kanamasına (n=12) ve mukozal kanamaya (n=7) rastlanıldı. Ayrıca değerlendirilmeye alınan diyabetik hastalarda trombositopeni gelişimi anlamlı olarak daha sıktı (r=0.108, p<0.05). Sonuç: Kardiyovasküler cerrahi yoğun bakım hastalarında trombositopeni önemli bir mortalite ve morbidite nedenidir. Özellikle operasyon sonrası sıklıkla antikoagülan tedavi başlanan bu hastalarda peroperatif dönemde hemostaza ayrıca önem verilmeli, postoperatif yoğun bakımda ise hastaların kan parametreleri yakın takip edilmelidir.
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  • 3
191-197
  • Turkish

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Yazışma Adresi:
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