Nazlı ÇETİN, Hande ŞENOL, Göksel ALTINIŞIK, Fikri Selçuk ŞİMŞEK, Erhan UĞURLU, Nilüfer YİĞİT, Ümit AYDOĞMUŞ, İlknur Hatice AKBUDAK

Coil tedavisi yapılmış olan amfizem hastalarının solunum fonksiyon testlerinin ve yaşam kalitesi değerlendirme anketlerinin retrospektif olarak incelenmesi

Giriş: Optimal medikal tedaviye rağmen dispneik seyreden seçilmiş amfizem hastalarında bronkoskopik volüm küçültme tedavileri önemli bir alternatiftir. Merkezimizde coil işlemi yapılan KOAH’lı hastaların geriye dönük takip verilerini tarayarak, coil işleminin KOAH’lı hastalarda solunumsal semptom ve solunum fonksiyon testlerine etkisi olup olmadığını değerlendirmeyi amaçladık.Materyal ve Metod: 2017-2020 yılları arasında şiddetli amfizemi olan, coillerle tedavi edilen 41 hastanın verileri retrospektif olarak değerlendirildi. İşlem öncesi bütün hastaların kardiyopulmoner rehabilitasyon programları tamamlanmış, hastalar solunum fonksiyon testi (SFT), karbonmonoksit difüzyon testi (DLCO), vücut pletismografisi (body box), 6 dakika yürüme testi, ventilasyon/perfüzyon sintigrafisi, St. George Solunum Anketi (St. George’s Respiratory Questionnaire, SGRQ) ile değerlendirilmiştir. İşlem öncesi ve işlem sonrası 3. ay kontrol verileri kaydedilmiş, işlem öncesi olduğu gibi kontrollerde de SGRQ anketi Göğüs Hastalıkları’nda çalışmakta olan doktorlar tarafından yüz yüze görüşülerek yapılmıştır.Bulgular: Toplam 32 hastanın SGRQ anketleri değerlendirildi. İşlem öncesi hesaplanan semptom, aktivite, etki (impact) skoru ve toplam skorda işlem sonrası istatistiksel olarak anlamlı değişiklik gözlendi. SFT ile yapılan karşılaştırmada işlem öncesi ve sonrası FEV1, FVC, FEV1/FVC, PEF, FEF25/75 parametreleri kullanıldı. Çalışmaya dahil edilen 32 hastanın işlem öncesi ve sonrası SFT parametreleri karşılaştırıldığında FEV1, FVC, FEF25/75‘te istatistiksel olarak anlamlı değişiklik gözlendi.Sonuç: Bronkoskopik volüm küçültücü bir işlem olan coil işleminin sonrasında solunum fonksiyon parametrelerinde ve yaşam kalite-si anketlerinde anlamlı bir düzelme olduğu saptanmıştır.

A retrospective evaluation of the pulmonary function tests and quality of life assessment surveys of emphysema patients subject to coil treatment

Introduction: Bronchoscopic volume reduction treatments are among the important alternatives for selected emphysema patients with a dyspneic cour-se despite optimal medical treatment. Our aim was to carry out a retrospecti-ve scan of the data for COPD patients subject to coil treatment at our center for assessing whether coil procedure has an impact on the respiratory symptom and pulmonary function tests in COPD patients.Materials and Methods: The data of 41 patients with severe emphysema and treated with coils between 2017-2020 were evaluated retrospectively. Cardiopulmonary rehabilitation programs were completed for all patients prior to the procedure and they were assessed with pulmonary function test (PFT), diffusing capacity for carbonmonoxide test (DLCO), body plethysmography, 6-minute walk test, ventilation/perfusion scintigraphy, St. George’s Respiratory Questionnaire (SGRQ). Data acquired prior to the procedure and 3rd month control data after the procedure were recorded and SGRQ was app-lied via face-to-face interviews during the controls by doctors working on Pulmonary Diseases as was the case before the procedure.Results: SGRQ questionnaires of 32 patients were evaluated. Statistically significant changes were observed after the procedure in symptom, activity, impact score and total score which were calculated prior to the procedure. Pre and post procedure FEV1, FVC, FEV1/FVC, PEF, FEF25/75 parameters were used for the comparison made via SFT. Statistically significant changes were observed in FEV1, FVC, FEF25/75 when the pre and post-procedure SFT parameters of the 32 patients included in the study were compared.Conclusion: A statistically significant improvement was observed in the PFT parameters and quality of life questionnaires following the coil procedure which is a bronchoscopic volume reduction procedure.

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