Ceyda ANAR, Dursun TATAR, İpek ÜNSAL, Yasemin ÖZDOĞAN, Hüseyin HALİLÇOLAR

ACİL SERVİSTE İZLENEN KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI VE AKCİĞER KANSERİ OLAN OLGULARIN ÖZELLİKLERİ

Acil servise başvuran kronik obstrüktif akciğer hastalığı (KOAH) ve akciğer kanseri birlikteliği olan olguların genel özelliklerini değerlendirmek. Hastanemiz acil servisine Ocak 2007-Haziran 2007 tarihleri arasında başvuran KOAH ve akciğer kanseri birlikteliği olan 86 olgunun kayıtları retrospektif olarak incelendi. Çalışmaya alınan 86 olgunun 6 (%6.9)'sı kadın, 80'i (%93.1) erkek olup yaş ortalaması 65.3 (37- 81) idi. Olgularn 76 (%88.3)'sı sigara içicisiydi ve ortalama 57.4 (0-150) paket/yılı sigara kullanma öyküsü vardı. Olgularımızda saptanan en sık semptomlar nefes darlığı (%100), öksürük (%88.3) ve balgam çıkarma (%40.6) idi. Daha az sıklıkta kilo kaybı (%40.6), göğüs ağrısı (%33.7) ve hemoptizi (%16.2) izlendi.Radyolojik olarak sıklıkla kitle lezyonu (%97.6), mediastinal ve/ veya hiler lenfadenopati (%83.7) ve atelektazi (%18.6) saptandı. Lezyonların en sık sağ üst lobda (%33.7) yerleştiği, bunu sağ hilus (%22.1) ve sol üst lobun (%20.9) izlediği görüldü. Patolojik tanı 43 (%36.9) olguda küçük hücreli dışı akciğer karsinomu (KHDAK), 14(%12.04) olguda squamöz hücreli akciğer karsinomu, 10 (%8.6) olguda adeno karsinomu, 1 olguda da büyük hücreli akciğer karsinomu ve 14 %16.4) olguda küçük hücreli akciğer karsinomu (KHAK) idi, 4 (%4.8) olguda patolojik tanıya ulaşılamadı. Olguların büyük çoğunluğu (63 olgu, %73.2) lokal ileri ve ileri evre hastalığa sahipti. Olguların 36'sına (%41.8) kemoterapi, 15'ine (%17.5) radyoterapi, 16Ôsına (%18.6) kemoterapi ve radyoterapi, 4'üne (%4.8) cerrahi tedavi uygulanmış olup, 15(%17.5) olgu semptomatik tedavi ile izlenmekteydi. KOAH'lı akciğer kanseri olgularının en sık acil başvuru semptomu nefes darlığı ve en sık acil başvuru nedeni solunum yetmezliği idi.

Anahtar Kelimeler:

Akciğer kanseri, KOAH, Acil servis

CHARACTERISTICS OF THE LUNG CANCER CASES WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE FOLLOWED IN EMERGENCY ROOM

To evaluate the characteristics of the cases with chronic obstructive pulmonary disease (COPD) and lung cancer concurrently referred to emergency room. The data of 86 cases referred to emergency service with COPD and lung cancer concurrently between the dates of January and June 2007 were evaluated retrospectively. 80(93.1%) of cases were men and six (6.9%) were women, mean age was 65.3years(37-81). Seventy-six of cases (88.3%) were smokers. The most frequent symptom for referral to emergency room was dyspnea and it was present in all cases. Cough (88.3%), sputum expectoration (40.6%) and weight loss (40.6%) were other the most common symptoms. The most frequent radiological lesions were mass lesion (97.6%) and hilar and/or mediastinal lenfadenopathy (83.7%). Diagnosis of lung cancer was based on histopathology in 82 cases (95.2%) and clinic-radiologic findings dosyain 4 cases (4.8%). The most common cancer type was non small cell lung cancer (NSCLC) (n:43, 36.9%). 14(12.04%) caseses were squamöz lung cancer, 10 cases were adenocarsinoma and 14 cases were small cell lung carcinoma. When assessed in terms of organ metastasis, it was observed that the most frequent one was adrenal metastasis (8.0%). Chemotherapy was performed in 36 (41.8%) cases, radiotherapy in 15 (17.5%), surgery in 4 (4.8%) and 15 (17.5%) subjects were followed by symptomatic therapy. The most frequent symptom for referral was dyspnea and the most frequent cause for referral was respiratory insufficiency in COPD-patients with lung cancer.

Keywords:

Lung cancer, COPD, Emergency room,

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