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CERRAHİ KLİNİKLERİNDE TEDAVİ EDİLEN BARSAK TIKANMASI OLGULARININ RETROSPEKTİF DEĞERLENDİRİLMESİ

RETROSPECTIVE INVESTIGATION OF PATIENTS HAVING AN INTESTINAL OBSTRUCTION OPERATION IN GENERAL SURGERY CLINICS

Journal Name:

  • Uluslararası İnsan Bilimleri Dergisi

Publication Year:

  • 2004
Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
In this study, a total of 165 patients consisting of 117 male and 48 female, ranging between 9 and 100 ages, having an intestinal obstruction as a diagnosis in the General surgery clinics of Haydarpaşa Numune Hospital are investigated retrospectively. Without taking into account of the socioeconomic differences among the patients; age , sex, history, referring time to the hospital, symptoms, physical examination, signs. Hospitalisation time, diagnosis, biochemical parameters, treatment modalities and prognosis are taken from the archives recordings in a detailed fashion. As a result of the study, we had the findings consistent with the previous findings stating that the intestinal obstruction aetiology had changed dramatically both in developed countries and in developing countries like our country. Adhesions due to the previous surgical operations are the leading cause in the intestinal obstruction aetiology. Adhesions following the appendectomy operation is the most encountered cause. As the appendectomy is the most performed surgical operation, it is normal that it is the encountered the most. It is also important to know the number of the perforated appendiscites. If the incidence of tne perforated appendicites is high, early diagnosis of the acute appendicites diminish the incidence of brit ileus as well. Early diagnosis is important responsability of family medicine specialist in the first step health in general. The incidence of inteztinal obstructions due to the malignities in our country is less encountered than it is seen in the developped contries. That's because of the different nutritional habits in our country compared with the developed countries and the short life expectancy of the Turkish people.
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Abstract (Original Language): 
Bu çalışmada, 1995-1998 yılları arasında Haydarpaşa Numune Hastanesinde Cerrahi Kliniklerinde barsak tıkanıklığı tanısı almış, yaşları 9 ile 100 arasında değişen, 117 erkek 48 kadın olmak üzere toplam 165 hasta retrospektif olarak değerlendirilmiştir. Hastaların sosyoekonomik farklılıkları göz önüne alınmadan yaş, cinsiyet ,özgeçmiş, hastaneye başvuruş süreleri, semptomları, fizik muayane bulguları, hastanede yatış süreleri, aldıkları tanı, biyokimyasal parametreleri, tedavi yaklaşımları ve prognoz ayrıntılı olarak arşiv kayıtlarından incelenmiştir. Çalışmanın sonucunda, son yıllarda barsak tıkanması etyolojisinde hem gelişmiş ülkeler, hem de özellikle ülkemiz gibi gelişmekte olan ülkelerde önemli değişiklikler olduğu yolundaki bulgularla uyumlu sonuçlar elde edilmiştir. Barsak tıkanması nedenleri arasında, önceden geçirilmiş olan cerrahi operasyonlar nedeniyle ortaya çıkan adezyonların ilk sırada geldiği gösterilmiştir. Apandektomi sonucu adezyon oluşumu, en sık görülen nedendir. Bu durum, apandektomilerin en sık yapılan operasyon olmasından kaynaklanır. Apandektomilerin kaçının perfore apandisit olduğunu bilmek önem taşır. Perfore apandisitlerde eğer oran yüksek ise, akut apandisitin erken teşhisi göreceli olarak brit ileus oranını da azaltır. Erken teşhis, Aile Hekimliği uzmanın ilk basamakta önemli bir sorumluluğu olarak karşımıza çıkmaktadır. Gelişmiş ülkelerde ön sıralarda yer alan malignite sonucu ortaya çıkan barsak tıkanmalarına ülkemizde daha az sıklıkla rastlanmaktadır. Buna neden olarak, ülkemizdeki diyet alışkanlığının gelişmiş ülkelerden farklılık göstermesi ve Türk halkının ortalama yaşam süresinin daha kısa olması düşünülebilir.Volvulus nedenli barsak tıkanmalarının da çalışmamızda daha az görülmesi, diyet alışkanlığı ve yaş ortalaması ile açıklanabilir. Bu verilerin ışığında, barsak tıkanması olgularının teşhisi, muayenesi ve tedavisinin prognoz açısından önem taşıdığı saptanmıştır. Hasta ne kadar erken hekime başvurursa o kadar yüz güldürücü sonuçlar alınabilir, komplikasyonlar azaltılabilir. Aile Hekimliği uzmanının da barsak tıkanıklığı nedeniyle kendisine başvuran hastayı değerlendirmesi ve ilgili acil cerrahi birimle işbirliği önem arz etmektedir.
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