Emine EMEKTAR, Seda DAĞAR, Hüseyin UZUNOSMANOĞLU, Yunsur ÇEVİK

Acil serviste trombolitik tedavi alan pulmoner tromboemboli hastaların analizi

Giriş Pulmoner emboli (PE), pulmoner arterlerin tıkanması sonucu ortaya çıkan hayatı tehdit eden ancak potansiyel olarak geri dönüşümlü bir acil durumdur. Bu çalışmada trombolitik tedavi uygulanan pulmoner emboli hastalarının demografik özelliklerini, laboratuvar verilerini ve mortalite oranlarını değerlendirmeyi amaçladık. Gereç ve Yöntem Çalışma retrospektif bir çalışmadır. Acil serviste PE için trombolitik tedavi alan hastalar dahil edildi. Hastaların demografik verileri, komorbiditeleri, fizik muayene bulguları ve laboratuvar parametreleri retrospektif olarak kaydedildi. Sonuçlar Çalışmaya 16 hasta dahil edildi. En sık görülen semptomlar dispne (% 68.8), senkop (% 62.5) ve göğüs ağrısı (% 23.5) idi. Dokuz hasta acil servise kardiyak arrest olarak getirildi ve 4 hasta acil serviste öldü. 30 günlük mortalite oranı% 58.8 idi. Demografik ve laboratuvar parametreleri ölen ve sağ kalan hastalarda 30 günlük mortaliteye göre karşılaştırıldığında, iki grup arasında herhangi bir parametrede istatistiksel olarak anlamlı bir fark yoktu. (tüm parametreler için p> 0.05). Sonuç Sistemik trombolitik tedavi, şok, derin hipotansiyon veya hemodinamik unstabil olan PE hastaları için ilk tedavi seçeneğidir. Bu çalışmada hemodinamik instabilite veya kardiyak arrest ile acil servise başvuran hastalarda, laboratuvar parametrelerinin anormal olduğunu, daha düşük dozda trombolitik tedavi aldıklarını ve daha yüksek mortaliteye sahip olduklarını gösterdik.

Anahtar Kelimeler:

pulmoner tromboemboli, trombolitik tedavi, acil servis

Analysis of patients with pulmonary thromboembolism who received thrombolytic therapy in the emergency department

Introduction Pulmonary embolism (PE) is a life-threatening but potentially reversible emergency condition that occurs as a result of the obstruction of pulmonary arteries. We aimed to assess the demographic features, laboratory data, and mortality rates of patients with pulmonary embolism who were administered thrombolytic therapy in this study. Material and methods This was a retrospective study. It enrolled patients who received thrombolytic therapy for PE at the Emergency Medicine. The demographic data, comorbidities, physical examination findings and laboratory parameters of the patients with PE were retrospectively recorded. Results Sixteen patients were enrolled during the study. The most common symptoms were dyspnea (68.8%), syncope (62.5%), and chest pain (23.5%). Nine patients were brought to the emergency department with cardiac arrest, and 4 patients died at the emergency department. The 30-day mortality rate was 58.8%. When demographic and laboratory parameters were compared according to 30-day mortality among the patients who died and survived, there was no statistically significant difference in any parameter between the two groups. (p>0.05 for all parameters). Conclusion Systemic thrombolytic therapy is the first treatment option for patients with PE who are in shock or who have profound hypotension or hemodynamic instability. In this study, we showed that patients admitted to the emergency department with hemodynamic instability or cardiac arrest were abnormal in laboratory parameters, received lower doses of thrombolytic therapy and had higher mortality.

Keywords:

pulmonary thromboembolism, thrombolytic therapy, emergency,

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