Denizli\u2019de 78 ya\u015f\u0131ndaki fel\u00e7li hastan\u0131n nefes borusuna ka\u00e7an m\u0131s\u0131r tanesi 5 ay sonra ortaya \u00e7\u0131kt\u0131. Akci\u011ferine enfeksiyonu \u015fikayetlerinin tekrarlamas\u0131yla ortaya \u00e7\u0131kan olayda, ya\u015fl\u0131 kad\u0131n\u0131n sa\u011f akci\u011ferinin tamamen kapal\u0131 oldu\u011fu anla\u015f\u0131ld\u0131.<\/p>\n
Denizli\u2019de ya\u015fayan ve emekli \u00f6\u011fretmen olan 78 ya\u015f\u0131ndaki fel\u00e7li kad\u0131n son zamanlarda s\u0131k s\u0131k akci\u011fer enfeksiyonu nedeniyle hastaneye gidiyordu. 1 ay \u00f6nce gitti\u011fi hastanede bronkoskopi yap\u0131lmas\u0131na ra\u011fmen sorun saptanmad\u0131\u011f\u0131 \u00f6\u011frenildi. Ya\u015fl\u0131 kad\u0131n\u0131n son gitti\u011fi hastanede sa\u011f akci\u011ferinin tamamen kapand\u0131\u011f\u0131n\u0131n tespit edilmesi \u00fczerine Pamukkale \u00dcniversitesi Hastanesine ba\u015fvuruldu. PA\u00dc Hastaneleri G\u00f6\u011f\u00fcs Hastal\u0131klar\u0131 Anabilim Dal\u0131 \u00d6\u011fr. \u00dcyesi Prof. Dr. G\u00f6ksel Alt\u0131n\u0131\u015f\u0131k Ergur, taraf\u0131ndan yap\u0131lan tetkiklerde sa\u011f akci\u011fere giden hava yolunun b\u00fct\u00fcn\u00fcyle kapal\u0131 oldu\u011fu g\u00f6r\u00fcld\u00fc. hastaya acil bronkoskopi planlan\u0131p hemen i\u015flemin ger\u00e7ekle\u015ftirildi\u011fini s\u00f6yleyen Prof. Dr. Alt\u0131n\u0131\u015f\u0131k Ergur, “Fleksibl (esnek, e\u011filip b\u00fck\u00fclebilir) bronkoskop ile hava yollar\u0131 incelenirken \u00e7ok yo\u011fun ve koyu sekresyon oldu\u011fu, bunun iyice temizlenmesi sonucunda ancak hava yollar\u0131n\u0131n incelenebilece\u011fi g\u00f6r\u00fcld\u00fc. Aspirat\u00f6r (i\u00e7erideki salg\u0131lar\u0131 emmeye yarayan bir cihaz) sayesinde hava yollar\u0131na steril s\u0131v\u0131 verilip emilerek bu temizlik yap\u0131ld\u0131. Sonras\u0131nda sa\u011f akci\u011fere giden hava yolunda sar\u0131 bir nesne oldu\u011fu g\u00f6r\u00fcld\u00fc. Bu h\u00e2liyle yabanc\u0131 cisim oldu\u011fu anla\u015f\u0131ld\u0131\u011f\u0131 gibi bunun m\u0131s\u0131r tanesine benzerli\u011fi de a\u00e7\u0131kt\u0131. Yabanc\u0131 cismi \u00e7\u0131karma i\u015flemi genel anestezi alt\u0131nda, rijit bronkoskop ile yap\u0131lmak \u00fczere planlanabilirdi; \u00e7\u00fcnk\u00fc bu durumun tedavisi yabanc\u0131 cismin oradan, ek sorun olu\u015fturmaks\u0131z\u0131n \u00e7\u0131karmakt\u0131. Ancak, genel anestezi alt\u0131ndaki bir i\u015flem i\u00e7in hastan\u0131n genel durumu bozuk oldu\u011fundan, \u00f6zellikle ek hastal\u0131klar\u0131 ve enfeksiyon varl\u0131\u011f\u0131 ile i\u015flem riski artaca\u011f\u0131ndan hastadaki cismin fark edildi\u011fi s\u0131rada \u00e7\u0131kar\u0131lmas\u0131na \u015fans vermek daha uygun g\u00f6r\u00fcld\u00fc. Hava yolu i\u00e7indeki s\u0131v\u0131lar\u0131 emen aspirat\u00f6r\u00fcn g\u00fcc\u00fcn\u00fc kullan\u0131larak cismin \u00e7\u0131kar\u0131lmas\u0131 m\u00fcmk\u00fcnd\u00fc. Bronkoskobun ucu, sar\u0131 cismin g\u00f6vdesine dayan\u0131p aspirat\u00f6r ile emme sayesinde ikisi birbirine s\u0131ms\u0131k\u0131 yap\u0131\u015ft\u0131r\u0131ld\u0131. Emme g\u00fcc\u00fcn\u00fcn azalt\u0131lmamas\u0131na dikkat ederek yabanc\u0131 cisim ve bronkoskop, ayn\u0131 zamanda hava yollar\u0131ndan d\u0131\u015far\u0131ya ba\u015far\u0131 ile \u00e7\u0131kar\u0131ld\u0131. \u0130\u015flem sonras\u0131nda hasta yak\u0131n\u0131na m\u0131s\u0131r tanesi a\u00e7\u0131s\u0131ndan t\u0131bbi \u00f6yk\u00fc yeniden soruldu\u011funda, hastam\u0131z\u0131n bundan be\u015f ay \u00f6nce yedi\u011fi pizzan\u0131n \u00fczerinde m\u0131s\u0131r taneleri oldu\u011fu \u00f6\u011frenildi. O s\u0131rada ani bir yak\u0131nma ortaya \u00e7\u0131kmad\u0131\u011f\u0131 i\u00e7in b\u00f6yle bir ihtimal akla gelmemi\u015fti. D\u00fc\u015fk\u00fcn hastalar taneli g\u0131dalar yerken, bu durumun fark edilmeden de geli\u015febilece\u011fini g\u00f6stermesi a\u00e7\u0131s\u0131ndan \u00f6nemli olan bu tablo, hastalar\u0131n bir dedektif titizli\u011fi ile de\u011ferlendirilmesi gereklili\u011fini bir kez daha ortaya koymaktad\u0131r” dedi.<\/p>\n
“Heimlich manevras\u0131 ya da \u00f6ks\u00fcr\u00fckle cisim d\u0131\u015far\u0131 at\u0131lamazsa, bronkoskopi ile m\u00fcdahale gerekir”
\n
Hava yoluna yabanc\u0131 cisimlerin ka\u00e7mas\u0131n\u0131n ani ve beklenmedik kazalar sonucu ortaya \u00e7\u0131kt\u0131\u011f\u0131n\u0131 ifade eden PA\u00dc Hastaneleri G\u00f6\u011f\u00fcs Hastal\u0131klar\u0131 Anabilim Dal\u0131 \u00d6\u011fr. \u00dcyesi Prof. Dr. G\u00f6ksel Alt\u0131n\u0131\u015f\u0131k Ergur, “Normalde yemek borusu ile soluk borusu aras\u0131nda yer alan epiglot adl\u0131 kapak, g\u0131dalar\u0131n yanl\u0131\u015fl\u0131kla hava yollar\u0131na ka\u00e7mas\u0131n\u0131 \u00f6nler. Ancak g\u00fclme, konu\u015fma gibi durumlarda ya da yatar pozisyonda beslenen bak\u0131m hastalar\u0131nda bu koruyucu mekanizma devre d\u0131\u015f\u0131 kalabilir. Kuru yemi\u015f, nohut, s\u0131v\u0131 g\u0131dalar, i\u011fne, di\u015f protezi gibi yabanc\u0131 cisimler hava yollar\u0131na ka\u00e7t\u0131\u011f\u0131nda \u00f6ks\u00fcr\u00fck refleksi devreye girerek g\u00fc\u00e7l\u00fc \u015fekilde tepki verir. Cisim b\u00fcy\u00fckl\u00fc\u011f\u00fc ve t\u0131kad\u0131\u011f\u0131 b\u00f6lgeye ba\u011fl\u0131 olarak nefes darl\u0131\u011f\u0131, morarma ve hatta \u00f6l\u00fcm meydana gelebilir. \u0130lk a\u015famada Heimlich manevras\u0131 ya da \u00f6ks\u00fcr\u00fckle cisim d\u0131\u015far\u0131 at\u0131lamazsa, bronkoskopi ile m\u00fcdahale gerekir. Bu i\u015flem genellikle genel anestezi alt\u0131nda rijit bronkoskop ad\u0131 verilen metal bir t\u00fcple ger\u00e7ekle\u015ftirilir. Yabanc\u0131 cismin \u00e7\u0131kar\u0131lmamas\u0131 durumunda, akci\u011ferde hava giri\u015f \u00e7\u0131k\u0131\u015f\u0131n\u0131n durmas\u0131 sonucu s\u00f6nme (atelektazi) ve diren\u00e7li enfeksiyonlar geli\u015febilir. Bu da kal\u0131c\u0131 akci\u011fer hasar\u0131na yol a\u00e7abilir” ifadelerini kulland\u0131.
<\/p>\n","protected":false},"excerpt":{"rendered":"
Denizli\u2019de 78 ya\u015f\u0131ndaki fel\u00e7li hastan\u0131n nefes borusuna ka\u00e7an m\u0131s\u0131r tanesi 5 ay sonra ortaya \u00e7\u0131kt\u0131. Akci\u011ferine enfeksiyonu \u015fikayetlerinin tekrarlamas\u0131yla ortaya \u00e7\u0131kan olayda, ya\u015fl\u0131 kad\u0131n\u0131n sa\u011f akci\u011ferinin tamamen kapal\u0131 oldu\u011fu anla\u015f\u0131ld\u0131. Denizli\u2019de ya\u015fayan ve emekli \u00f6\u011fretmen olan 78 ya\u015f\u0131ndaki fel\u00e7li kad\u0131n son zamanlarda s\u0131k s\u0131k akci\u011fer enfeksiyonu nedeniyle hastaneye gidiyordu. 1 ay \u00f6nce gitti\u011fi hastanede bronkoskopi…<\/p>\n","protected":false},"author":1,"featured_media":43849,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_crdt_document":"","footnotes":""},"categories":[2],"tags":[],"class_list":["post-43848","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-saglik"],"_links":{"self":[{"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/posts\/43848","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=43848"}],"version-history":[{"count":1,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/posts\/43848\/revisions"}],"predecessor-version":[{"id":43850,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/posts\/43848\/revisions\/43850"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/media\/43849"}],"wp:attachment":[{"href":"https:\/\/www.egemtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=43848"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=43848"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=43848"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}