Koray DURAL, Makbule BALDEMİR, Bülent KOÇER, Serdar HAN, Ünal SAKINCI, Erkan YILDIRIM, Kanat ÖZIŞIK

Düşük yüzdeli travmatik pnömotoraksta tedavi

Travmatik pnömotorakslarda tüp torakostomi (TT) halen en önemli tedavi yöntemidir. Pnömotoraks oranı düşük olan uygun hastalarda gözlem ve gerekirse cerrahi müdahale uygulamak bir seçenek olabilir. Kliniğimizde düşük yüzdeli travmatik pnömotorakslı hastalarda uyguladığımız gözlem ve tedavi sonuçlarını gözden geçirdik. Ocak 2000-Ocak 2002 tarihleri arasında Ankara Numune Hastanesi Göğüs Cerrahisi Kliniği’nde travmatik düşük yüzdeli pnömotoraks nedeniyle takip ve tedavi edilen toplam 108 hasta künt travma, delici-kesici alet yaralanması ve ateşli silah yaralanması olmak üzere üç gruba ayrıldı. Hastaların hepsi cerrahi müdahale görmeksizin gözlem amacıyla yatırıldı. Altıncı saat, 12. saat ve daha sonra günlük film takibi yapıldı. Gözlem süresi içinde pnömotoraks yüzdeleri artan toplam 46 (%43) hastaya TT yapıldı. Pnömotoraks yüzdeleri %20 olanlarda (%69) ve 2’den fazla kot fraktürü olan hastalarda (%69) TT ihtiyacı daha fazlaydı. Düşük yüzdeli travmatik pnömotorakslı hastalarda cerrahi müdahalede bulunmadan gözlem altında tutmak uygun bir tedavi yöntemidir.

Treatment in patients with low traumatic pneumothorax ratio

Thoracostomy tube placement (TT) is currently one of the most important treatment modalities used in traumatic pneumothoraxpatients. In patients with low pneumothorax ratio (percentage), both follow-up without surgery and employing interventionwhen indicated may be appropriate choice. We presented the outcome of patients with low traumatic pneumothoraxratio treated by follow up without surgical intervention in our clinic. During the period from January 2000 until January2002, 108 patients who were treated and followed with low percentage traumatic pneumothorax in Ankara NumuneHospital Thoracic Surgery Clinic were allocated into three groups due to blunt trauma of the thorax, penetrating-cuttinginstrument injury and gunshot injury. All patients were admitted to the clinic with the purpose of observation without surgicalintervention and chest roentgenograms were taken at the sixth and twelfth hours and daily thereafter. TT was performedfor 46 (43%) patients whose pneumothorax ratio increased during the observation period. TT was more frequent in patientswith 20% percentage pneumothorax (69%) as well as with two or more fractured ribs (69%). Follow-up without surgicalintervention may one of the appropriate modes of treatment in patients who have minimal traumatic pneumothorax.

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