Aralik 2008
Çorum Devlet Hastanesi üst gastrointestinal sistem kanamali hastalarin degerlendirilmesi
The evaluation in Corum national hospital patients with upper gastrointestinal system bleeding
- Ana Sayfa
- Sayılar
- Aralik 2008
- Çorum Devlet Hastanesi üst gastrointestinal sistem kanamali hastalarin degerlendirilmesi...
Özet
Giris ve Amaç: Üst gastrointestinal sistem kanama tanisi ile basvuran ve takip edilen olgularimizin özelliklerini degerlendirmek. Gereç ve Yöntem: 2006 Mayis-2007 Mayis dönemi arasinda Çorum Devlet Hastanesine yatan üst GIS kanamali hastalar retrospektif olarak incelendi. Hastalar yas, cinsiyet, basvuru sikayetleri, ek hastaliklari, ilaç kullani mi, kanama öyküsü, laboratuvar degerleri, endoskopik bulgular, uygulanan tedavi, transfüzyon ihtiyaci, yatis süresi ve mortalite açisindan degerlendirildi. Bulgular: Toplam 97 hasta yatisi oldu. Hastalarin 66'si (%68.1) erkek, 31'i (%31.9) kadin (p<0.05) di. Basvuru sikayetleri; melena 58 (%60.5) kisi, hematemez 14 kisi, hematemez ve melena 25 (%25) kisiydi. Hastalarin kullandigi ilaçlar; nonsteroidal antiinflamatuvar ilaçlar 22 (%23) kisi, aspirin 14 (%14.5) kisi, klopidogrel 7 (%8) kisi, oral antikoagülan ilaçlar ve aspirin 11 (%12) kisi, bilinen ilaç kullanim öyküsü olmayanlar 43 (%42.5) kisidir. Basvuran hastalarin 18 (%18.5)’inde koroner arter hastaligi, 21 (%21.6) kiside by pass öyküsü, 11 (%10.6) kiside diabetes mellitus, 17 (%16.4) kisi koroner arter hastaligi ve diabetes mellitus, 16 (%15.5) kisi çesitli eklem agrilari nedeniyle ilaç kullanan hastalar, 5 (%4.85) kisi serebrovasküler hastalik tanisi ile tedavi gören hastalar, 9 (%8.7) kisi bilinen bir rahatsizligi olmayanlardi. Ortalama gelis hemoglobini 7.2 g/dl, hematokrit %21’di. Üst gastrointestinal sistem endoskopisinde en sik saptanan bulgular sirasiyla; bulbus ülseri 37 (%35.8) kisi, eroziv gastrit 16 (%15.5) kisi, Mide ülseri 25 kisi (korpus ülseri %9.3, antrum ülseri %14.9) mide kanseri 9 kisi (%8.7), Malt lenfoma 4 (%3.8) kisi, özofagus varisi 6 (%5.8) kisi bulundu. Sonuç: Koroner arter hastaligi, serebrovaskuler hastaligi, diabetes mellitus ve romatizmal hastaligi olanlarda gastrik sikayetler var ise tedavilerine mide asit inhibitörü eklenmesinde fayda vardir.
Abstract
Background and Aims: The aim was to assess the characteristics of patients with upper gastrointestinal system bleeding in our clinic. Materials and Methods: The patients with upper gastrointestinal system bleeding admitted to Çorum State Hospital Gastroenterology Department between May 2006 - May 2007 were retrospectively evaluated. The patients were assessed for age, sex, complaints, history of medication, management, history of bleeding, laboratory findings, endoscopic findings, need for transfusion, hospitalization duration and mortality. Results: Ninety- seven patients with upper gastrointestinal system bleeding admitted to our department. Of the patients, 66 (68.1%) were male and 31 (31.9%) were female (p<0.05). Complaints at admission included melena 58 (60.3%) patients, hematemesis 14 (14.5%) patients and both hematemesis and melena 25 (25%) patients. Twenty-two (23%) of the patients were using nonsteroidal antiinflammatory drugs, 14 (14.5%) patients aspirin, 7 (8%) patients clopidogrel, 11 (12%) patients both oral anticoagulants and aspirin and 43 (42.5%) patients no drugs. Of the patients, 18 (18.5%) had coronary artery disease, 21 (21.6%) had coronary artery disease and bypass operation, 11 (10.6%) had diabetes mellitus, 17 (16.4%) had coronary artery disease and diabetes mellitus, 16 (15.5%) had a history of nonsteroidal antiinflammatory drugs for arthralgia, 5 (4.85%) had cerebrovascular disease, and 9 (8.7%) had no other disease. The mean hemoglobin was 7.2 g/dl, and the mean hematocrit was 21.0%. The findings at upper gastrointestinal system endoscopy were: bulbus ulcer in 37 (35.8%) patients, erosive gastritis in 16 (15.5%) patients, gastric ulcer in 25 patients (corpus 9.3%, antrum 14.9%), gastric (adeno) cancer in 9 (8.7%) patients, malt lymphoma in 4 (3.8%) patients and esophageal varices in 6 (5.8%) patients. Conclusions: Patients with coronary heart disease, cerebrovascular disease, rheumatological disease and diabetes mellitus should be given acid suppressor therapy if they have gastric complaints.
