ÇOCUK ACİL SERVİSTE SPONTAN PNÖMOTORAKS TANISI ALAN HASTALARIN RETROSPEKTİF OLARAK DEĞERLENDİRİLMESİ

Year 2025, Volume: 26 Issue: 1, 61 - 68, 27.01.2025

Gülşen Yalçın , Özlem Özdemir Balcı , Barkın Savaş Tonak , Ümit Dede , İlkay Kılıççıoğlu , Murat Anıl

https://doi.org/10.18229/kocatepetip.1491434

Abstract

AMAÇ: Spontan pnömotoraks (SP) pediatrik popülasyonda nadir görülen bir durumdur. Bu çalışmada SP’nin, klinik özellikleri, tedavi biçimleri ve sonuçlarının literatür verileri ışığında değerlendirilmesi amaçlandı.
GEREÇ VE YÖNTEM: Çalışmada, 2013 - 2023 tarihleri arasında çocuk acil servisine başvuran SP tanısı almış hastaların yaş, cinsiyet, boy, vücut kitle indeksi (VKİ), sigara içme ve madde bağımlılığı öyküsü, başvuru şikayeti, radyolojik bulguları, pnömotoraksın lokalizasyonu, pnömotoraks yüzdeleri, uygulanan tedavi, tedavi süresi, nüks ve tedavinin sonuçları belirlendi.
BULGULAR: Çalışmaya toplam 21 hasta dahil edildi. Olguların %95,2 erkek hasta ve yaş ortalaması 16,1±1,1 yıl olarak bulundu. Ortalama kilo=56,5±6,7 kg ve boy=175,2 ± 5,03 cm idi. Boy standart deviasyon skoru (SDS)=0.48±0,41, kilo SDS=-0.96± 0,42 ve VKİ SDS=-1,5± 0,47 idi. Klinik bulgu olarak en sık nefes darlığı (% 90,4) şeklindeydi. Toplam 12 hasta sigara, iki hastada sigara + madde bağımlılığı vardı. Kız hastada sigara içme öyküsü ve pnömotoraks olduğunda adet öyküsü vardı. Olguların %80,9 sol pnömotoraks mevcuttu. Göğüs bilgisayarlı tomografisi % 47 hastaya çekildi. Akciğer grafisinde hesaplanan pnömotoraksın oranı % 31,9±13,4 olarak bulundu. Tedavide % 42 hastaya tüp torakostomi, % 4,7 hastaya ponksiyon uygulandı. Diğer % 52 hastaya ise oksijen tedavisi uygulandı. Hastaların ilk geldiklerinde SpO2 değerleri ortalama %96,8±0,96 idi. Yapılan laboratuvar testlerinde patoloji saptanmadı. Hastaların % 90,4 yatış yapıldı. Ortalama hastanede yatış süresi 4,7±2,3 gün idi. İki hastada nüks gelişti. Hastalar ortalama 2 yıl izlendi.
SONUÇ: SP’li hastalarda acil ve etkili tedavi gerektirir. Çocukluk çağı SP’nin başlangıç tedavi yöntemleri arasında farklı uygulamalar mevcuttur. Standart yaklaşımın sağlanması amacıyla yeni çalışmalara ihtiyaç olduğunu düşünmekteyiz.

Keywords

Spontan Pnömotoraks, Etiyoloji, Tedavi, Prognoz, Çocuk

Ethical Statement

Çalışmanın başlatılmadan önce Buca Seyfi Demirsoy Eğitim ve Araştırma Hastanesi Girişimsel Olmayan Araştırmalar Etik Kurul (2024/257) onayı alındı.

Supporting Institution

YOK

Thanks

yok

RETROSPECTIVE EVALUATION OF PATIENTS DIAGNOSED WITH SPONTANEOUS PNEUMOTHORAX IN THE PEDIATRIC EMERGENCY DEPARTMENT

Abstract

OBJECTIVE: Spontaneous pneumothorax (SP) is a rare condition in the pediatric population. This study aimed to evaluate the clinical features, treatment methods and results of SP in the light of literature data.
MATERIAL AND METHODS: In the study, age, gender, height, body mass index (BMI) index, smoking and substance abuse history, complaint of admission, radiological findings, localization of pneumothorax, percentages of pneumothorax, applied treatment of patients diagnosed with SP who applied to the pediatric emergency department between 2013 - 2023 treatment duration, recurrence and treatment results were determined.
RESULTS: A total of 21 patients were included in the study. 95.2% of the cases were male and the average age was 16.1±1.1 years. Average weight=56.5±6.7 kg and height=175.2±5.03 cm. Height standard deviation score (SDS)=0.48±0.41, weight SDS=-0.96± 0.42 and BMI SDS=-1.5± 0.47 was. The most common clinical finding was shortness of breath (90.4%). A total of 12 patients had smoking addiction, and two patients had smoking + substance addiction. The female patient had a history of smoking and menstrual history when the pneumothorax occurred. There was left pneumothorax in 80.9% of the cases. Computerized tomography was performed in 47% patients. The rate of pneumothorax calculated on chest radiography was found to be 31.9±13.4%. In the treatment, tube therapy was applied to 42% patients and puncture was applied to 4.7% patients. The other 52% patients received oxygen therapy. The average SpO2 values of the patients when they first arrived were 96.8±0.96%. No pathology was detected in the laboratory tests performed. 90.4% of the patients were hospitalized. The average hospital stay was 4.7±2.3 days. Recurrence occurred in two patients. The patients were followed for an average of 2 years.
CONCLUSIONS: Patients with SP require urgent and effective treatment. There are different applications among the initial treatment methods for childhood SP. We think that new studies are needed to ensure a standard approach.

Keywords

Spontaneous Pneumothorax, Etiology, Treatment, Prognosis, Child

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