Agustos 2017
Karaciger sirozlu 225 hastanin retrospektif irdelenmesi: Tek merkez deneyimi
Retrospective analyses of 225 patients with liver cirrhosis: A single center experience
- Ana Sayfa
- Sayılar
- Agustos 2017
- Karaciger sirozlu 225 hastanin retrospektif irdelenmesi: Tek merkez deneyimi...
Özet
Giris ve Amaç: Bu çalismanin amaci klinigimizde yatmis olan karaciger sirozlu hastalarimizin yatis endikasyonlarini ve genel özelliklerini irdelemektir. Gereç ve Yöntem: Bu çalismada, Aralik 2011 ve Mayis 2013 tarihleri arasinda klinigimizde yatan 255 hasta retrospektif olarak degerlendirilmistir. Çalismaya alinma kriterleri; hastanede yatmis olmak, yatis öncesinde veya yatis sirasinda karaciger sirozu tanisi almis olmak, 18 yas üstü olmak ve tibbi verilerine tam olarak ulasilabiliyor olmak iken dislama kriterleri ise; ayaktan basvuran hastalar, siroz disi portal hipertansiyon varligi, 18 yas alti olmak ve tibbi verilerinde eksiklik olmasi olarak belirlenmistir. Bulgular: Otuz hastanin verileri tam olmadigi için çalismadan dislanmis olup çalismaya 225 hasta dahil edilmistir. Hastalarin çogunu erkekler (%70.2) olustururken erkeklerin ortalama yasi 62, kadinlarin ortalama yasi 67 bulunmustur. Baslica yatis nedenleri ileri girisimsel tedavi amaciyla hepatosellüler kanser (%21.8), hepatik ensefalopati (%21.3), asit etiyolojisini arastirmak (%20.4) ve varis kanamasi (%13.8) olarak tespit edilmistir. Etiyolojileri incelendiginde hepatit B virüsü ilk sirayi alirken (%32.8), bunu sirasiyla hepatit C virüsü (%21.3), kriptojenik (%20) ve alkole bagli nedenler (%18.2) izlemistir. Hastalarimizin çogunda (%83.6) varis saptanmistir. Hastalarimizin büyük bölümünü (%77.3) Child-Turcotte-Pugh skoru B ve C hastalari olusturmus, büyük bir çogunlugunda (%64) asit saptanmistir. Asitli olgularin %95’inde serum asit albümin gradientinin ?1.1 oldugu görülmüstür. Asit ponksiyonu yapilan hastalarimizin %8’inde spontan asit enfeksiyonu saptanmis, büyük bir çogunlugunun (%65) kültür negatif nötrositik asit oldugu görülmüstür. Toplamda 26 (%11.6) hasta yattigi süre içerisinde kaybedilmistir. Sonuç: Üçüncü basamak saglik merkezi olan hastanemizde hepatosellüler karsinomaya uygulanan girisimsel tedavi islemleri siroz hastalarinda en önemli yatis nedenlerinden birisi haline gelmistir.
Abstract
Background and Aims: The aim of this study was to evaluate our hospitalized patients with liver cirrhosis regarding hospitalization indications and general features. Materials and Methods: Two hundred and fifty-five patients with cirrhosis who were hospitalized between December 2011 and May 2013 were evaluated retrospectively in this study. The inclusion criteria were history of hospitalization, diagnosis either before or during hospitalization, being older than 18 years of age and having complete medical data. The exclusion criteria were outpatient cases, presence of noncirrhotic portal hypertension, being younger than 18 years of age, and having incomplete medical data. Results: Thirty patients were excluded from the study due to insufficient medical data; hence, the study included 225 cases. Most patients were male (70.2%), and the mean age was 62 years for males and 67 years for females. The most frequent hospitalization indications were hepatocellular carcinoma for further interventional treatments (21.8%), hepatic encephalopathy (21.3%), ascites of unknown etiology (20.4%), and variceal bleeding (13.8%). The etiological factors for cirrhosis were hepatitis B virus (32.8%), hepatitis C virus (21.3%), cryptogenic (20%), and alcohol (18.2%). Varices were found in most patients (83.6%). Most patients were in Child-Turcotte-Pugh classes B and C (77.3%). The majority of patients (64%) had ascites. The serum-ascites albumin gradient was ?1.1 in 95% of patients with ascites. Spontaneous ascites infection was found in 8% of patients who underwent ascitic fluid examination, and mostly cultured negative for neutrocytic ascites (65%). Overall, 26 (11.6%) patients died during hospitalization. Conclusion: Interventional treatments for hepatocellular carcinoma has become one of the most important hospitalization indications for patients with cirrhosis in our tertiary medical center.
