Plevral efüzyonlu hastalarda etiyolojik nedenler ve plevral kültür sonuçlarının retrospektif değerlendirilmesi

Year 2023, Volume: 4 Issue: 1, 34 - 39, 30.06.2023

Serpil Oğuz Mızrakçı , Sevil Alkan

https://doi.org/10.58208/cphs.1256553

Cited By: 1

Abstract

Amaç: Plevral efüzyon, birçok farklı hastalığın komplikasyonu olarak gelişebilir. Bu çalışmada, hastanemize plevral efüzyon nedeni ile yatırılan veya incelemeler sırasında plevral efüzyon saptanan hastaların efüzyon nedenlerinin, özelliklerinin ve plevral sıvı kültürlerinin değerlendirilmesi amaçlandı.
Gereç ve Yöntem: Çalışmada Nisan 2020-Haziran 2022 tarihleri arasında hastanede yatan plevral efüzyon saptanan ve torasentez işlemi uygulanan 18 yaşın üzerindeki hastalar retrospektif olarak değerlendirildi. Çalışmaya 84 hasta dahil edildi. Hastalara ait bulgular konsültasyon notları ve hastane otomasyon sisteminden elde edildi. Plevral sıvının yerleşimi unilateral (sağ veya sol) veya bilateral olarak kaydedildi. Plevral sıvının görünümü (seröz, hemorajik ve püy), biyokimyasal analizler ve plevra sıvısı kültürleri incelendi. Plevral efüzyonun eksüda-transüda ayrımı için Light kriterleri kullanıldı.
Bulgular: Hastaların yaş ortalaması 64,3±16,9 yıl ve 48'i (%57,1) erkek cinsiyette idi. 52(%61,9) hastada sağda, 19 (%22,6) hastada solda, 13 (%15,4) hastada bilateral plevral efüzyon saptandı. Plevral sıvı, en sık olarak 59 (%70,2) hastada seröz görünümde, 14 (%16,7) hastada hemorajik, 11 (%13,1) hastada pürülan görünümündeydi. 58 (%69) hastada eksüda, 26 (%30,9) hastada transüda saptandı. Olguların 16’sında (%19) malign plevral efüzyon saptandı. Malign plevral efüzyonu olanların yaş ortalaması 70,1±10,11 yıl olup, genel ortalamadan daha yüksekti. Transüdası olan 26 hastanın 18’i (%69,2) erkek cinsiyette idi. Eksüdası olanların ise 30’u (%51,7) erkek cinsiyette idi.
Sonuç: Plevral efüzyonun en sık nedenleri olarak sırasıyla kalp yetmezliği, malign hastalıklar, parapnömonik efüzyon ve ampiyem olarak tespit edildi. Bu hastalardan alınan plevral sıvı incelemeleri tedaviye yol göstermesi açısından faydalıdır.

Keywords

ampiyem, plevral efüzyon, plevral sıvı

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Retrospective evaluation of etiologic causes and pleural culture results in patients with pleural effusion

Abstract

Aim: Pleural effusion may develop as a complication of many different diseases. In this study, we aimed to evaluate the causes of effusion, characteristics, and pleural fluid cultures of patients who were hospitalized with pleural effusion or who were found to have pleural effusion during investigations.
Materials and Methods: In the study, patients over the age of 18 who were hospitalized between April 2020 and June 2022 and who were diagnosed with pleural effusion and underwent thoracentesis were retrospectively evaluated. The study included 84 patients. The findings of the patients were obtained from consultation notes and the hospital automation system. The location of pleural fluid was recorded as unilateral (right or left) or bilateral. The appearance of the pleural fluid (serous, hemorrhagic and purulent), biochemical analyses and pleural fluid cultures were analyzed. Light criteria were used for exudate-transudate differentiation of pleural effusion.
Results: The mean age of the patients was 64.3±16.9 years and 48 (57.1%) were male. 52 (61.9%) patients had right pleural effusion, 19 (22.6%) had left pleural effusion and 13 (15.4%) had bilateral pleural effusion. Pleural fluid was most commonly serous in 59 (70.2%) patients, hemorrhagic in 14 (16.7%) patients, and purulent in 11 (13.1%) patients. Exudate was found in 58 (69%) patients and transudate in 26 (30.9%) patients. Malignant pleural effusion was detected in 16 patients (19%). The mean age of patients with malignant pleural effusion was 70.1±11 years, which was higher than the general average. Of the 26 patients with transudates, 18 (69.2%) were male. Of those with exudates, 30 (51.7%) were male.
Conclusion: The most common causes of pleural effusion were heart failure, malignant diseases, parapneumonic effusion, and empyema. Pleural fluid examinations from these patients are useful in terms of guiding the treatment.

Keywords

empyema, pleural effusion, pleural fluid

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