Bengü BAKTIK, Nevin SEKMENLİ, Taha Tahir BEKÇİ, Burcu YALÇIN

Stabil kronik obstrüktif akciğer hastalığında diyafram kalınlığının ve fonksiyonunun ultrason tekniği ile değerlendirilmesi ve spirometri ile karşılaştırılması

Giriş: KOAH hastalarında dispne gelişiminde ve zayıf egzersiz toleransında rol alan patofizyolojik mekanizmalar karmaşık olmasına rağmen diyafram disfonksiyonu önemli bir rol oynar. Bu çalışmanın amacı, M-mod ve B-mod ultrasonografi ile ölçülmüş diyafram kalınlıkları ve diyafram ekskürsiyonu değerlerinin KOAH’lı hastalar ve sağlıklı gönüllülerle karşılaştırılmak ve KOAH’da hastalık şiddetini saptamada ultrason kullanımının katkısını değerlendirmektir. Materyal ve Metod: 67 KOAH hastası ve 53 sağlıklı gönüllü çalışmaya dahil edildi. B mod ve M mod ultrason ile diyafram kalınlık ve mobilite ölçümleri yapıldı ve kaydedildi. Bulgular: KOAH’lılarda derin inspiryumda ve derin ekspiryumda B mod ultrason ile ölçülen diyafram kalınlığının olmayanlara göre önemli ölçüde azaldığı saptandı (p= 0.004, p= 0.00). M mod ultrason ile değerlendirilen diyafram ekskürsiyonu KOAH olan grupta anlamlı ölçüde daha azdı. Sonuç: Bu çalışmada, KOAH olan hastalarda, diyafram kalınlığında ve mobilitede azalma ile birlikte diyafram disfonksiyonu geliştiğinin sonucuna vardık. KOAH’da ultrason kullanımı klinik uygulamaya katkı sağlayabilir ancak ileri çalışmalara ihtiyaç vardır.

Evaluation of diaphragm thickness and function with ultrasound technique and comparison with spirometry in stable chronic obstructive pulmonary disease

Introduction: Although the pathophysiological mechanisms involved in the development of dyspnea and poor exercise tolerance in chronic obstructive pulmonary disease (COPD) patients are complex, diaphragmatic dysfunction plays a significant role. The purpose of this study was to compare the diaphragm thicknesses and diaphragm excursion values measured by M-mode and B-mode ultrasonography with COPD patients and healthy volunteers and to evaluate the contribution of ultrasound use in determining disease severity in COPD. Materials and Methods: Sixty-seven COPD patients and 53 healthy volunteers were included in the study. Diaphragm thickness and mobility measurements were conducted and recorded with B mode and M mode ultrasound. Results: It was determined that the diaphragm thickness measured by B mode ultrasound in deep inspiration and deep expiration was significantly reduced in patients with COPD, compared to the ones without (p= 0.004, p= 0.00). Diaphragm excursion assessed by M mode ultrasound was significantly less in the COPD group. Conclusion: In this study, we concluded that the patients with COPD develop diaphragmatic dysfunction with reduced diaphragm thickness and mobility. The use of ultrasound in COPD may contribute to clinical practice, yet further studies are needed.

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