İlker YILMAN, Çakır Ebru İDİS, Gündeniz ALTIAY, Tuncay ÇAĞLAR

Trakya Ünüversitesi Tıp Fakültesi Göğüs Hastalıkları Servisi'nde 15 yıllık süreçte yatırılarak izlenen plevral efüzyonlu hastaların değerlendirilmesi

Plevral efüzyon gö ğüs hastalıkları pratiklerinde sık karşılaşılan problemlerden biridir. Bu çalışmada kliniğimizde yatırılarak izlenilen plevral efüzyonlu hastalarda etyoloji ve tanı yöntemlerini incelemeyi planladık.Trakya Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Kliniği'nde 1992-2007 tarihleri arasında plevral efüzyon tetkik nedeniyle yatırılarak izlenilen 558 hasta retrospektif olarak incelendi.Hastaların 227'si (%40.6) malignite, 168'i (%30.1) tüberküloz plörezi, 89'u (%15.9) parapnömonik efüzyon, 14'ü (%2.5) konjestif kalp yetmezliği olarak değerlendirildi. Kırk beş hastaya ise (%8.1) tanı konulamamıştı.Plevral efüzyonlu hastaların 137'sine (%24.6) plevra biyopsisi, 98'ine (%17.6) bronkoskopi, 8'ine (%1.4) video torokoskopi ile tanı konulmuştu. On dört (%2.5) hasta önerilen invaziv girişimi kabul etmemişti. Malignite olarak izlenilen 227 hastanın 188'ine (%82.8) invaziv girişimler ile tanı konuldu.On dokuzuna (%8.4) uygulanan invaziv işlemler ile tanı konulamamıştır, yirmi (%8.8) hastaya ise invaziv işlem uygulanamamış olup değerlendirilmeleri klinik ve radyolojik olarak yapılmıştı.Kliniğimizde takip edilen plevral efüzyonlu hastaların yaklaşık %70'i malignite ve tüberküloz tanısı almıştı. Bu nedenle özellikle üçüncü basamak sağlık kurumlarında ileri yaşta efüzyonlu hastalarda ön planda malignite, genç yaş grubunda ise öncelikle tüberküloz plörezi düşünülmesi gerektiğini bir kez daha vurgulamak istedik.

Evaluation of pleural effusion patients hospitalized in the Chest Department of Trakya University Medical Faculty in 15 years period

Pleural effusion is one of the common problems seen in chest diseases practice. In this study, we planned to investigate the etiology and diagnostic methods in pleural effusion patients who were hospitalized in our clinic.558 patients who were admitted to hospital due to pleural effusion in the Chest Clinic of Trakya University Medical Hospital in 1992-2007 were investigated retrospectively. Outpatients who were admitted to hospital in this period were excluded.Malignant pleural effusion was diagnosed in 227 (40.6%) patients, tuberculous pleurisy in 168 (30.1%), parapneumonic effusion in 89 (15.9%), and heart failure in 14 (2.5%). 45 (8.1%) patients remained undiagnosed. Of the patients with pleural effusion, 137 (%24.6) were diagnosed by pleural biopsy, 98 (%17.6) by bronchoscopy, 8 (%1.4) by video-assisted thoracoscopic surgery. 14 patients did not accept the invasive methods suggested. Of 227 patients with malignant pleural effusion, 188 (82.8) were diagnosed by invasive methods. 19 (8.4%) of them could not be diagnosed by the invasive methods applied.Invasive methods could not be performed in 20 (8,8%) patients and, therefore, their evaluations were made by clinical and radiological methods. Malignant pleural effusion and tuberculosis were diagnosed in approximately 70% of the patients who had pleural effusion and were followed in our clinic. We want to emphasize malignant diseases for the old patients with pleural effusion and tuberculous pleurisy for the young age group should be considered primarily.

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