Emel ALTUNCU, Ayfer ARDUÇ, Esin Aldemir YILDIZ, Seçil ALPASLAN, Nevzat ÇİZMECİ, Gülseren ARSLAN, Sultan KAVUNCUOĞLU, Ender AKSÜYEK, Engin ÖZTÜREGEN

Bronkopulmoner displazili hastalarımızın uzun dönem izleminde somatik büyüme, akciğer sorunları ve nörogelişimsel özelliklerinin irdelenmesi

Amaç: Bu çalışma bronkopulmoner displazi’li (BPD) hastaların yenidoğan dönemi sonrasındaki sorunları, büyüme ve nöromotor gelişmelerini değerlendirmek amacıyla yapıldı. Gereç ve Yöntem: 2003-2004 tarihleri arasında doğan ve yaşayan 39 olgudan 31’ine (%79) ulaşılarak 2006 yılı Temmuz ayında değerlendirildi. Bronkopulmoner displazili hastalara Grup I adı verildi. Kontrol grubu ise Grup I’deki her bir hastadan sonra hastanemizde doğan, en yakın tartı ve gebelik haftasında olan ve hiç mekanik vantilasyon desteği gerekmeyen erken doğmuş bebeklerden oluşturuldu ve Grup II olarak adlandırıldı. Grup II’deki hastalara ait bilgiler veri tabanından ve dosyalarından elde edildi. 21-42 ayda her iki grubun somatik büyüme ve nörogelişimsel süresi değerlendirildi. Bulgular: Grup I’deki hastaların 20’si (%64,5) bir veya daha fazla akciğer enfeksiyonu geçirirken, altısı bu nedenle hastaneye yatırıldı. Büyüme izleminde hastaların %38,7’sinde mikrosefali, %35’inde somatik büyüme geriliği bulundu. Nörogelişimsel değerlendirmede Denver Gelişimsel Tarama Testi (DGTT II), 10 (%32) erken doğmuş bebekte anormal bulunurken, Modifiye Amiel Tison’da 10 (%32) olguda yetersizlik, üç olguda sekel+yetersizlik bulundu. Bir hastada körlük gelişmişti. Grup II’de ise hastaların beşi birden fazla akciğer enfeksiyonu nedeniyle tedavi edilirken hastalardan birine reaktif hava yolu hastalığı tanısı kondu. Grup II’deki hastaların somatik büyüme özelliklerine bakıldığında; hastaların %10’unda somatik büyüme geriliği, %13’ünde mikrosefali bulundu. DGTT II, iki (%6) erken doğmuş bebekte anormal bulunurken, Modifiye Amiel Tison’da 4 (%16) olguda yetersizlik saptandı ancak hiçbirinde sekel gelişmemişti. Çıkarımlar: Literatürde somatik ve nörogelişimsel izlemde BPD’nin varlığı önemli bir hastalık nedeni olarak vurgulanmaktadır. Biz BPD’li hastalarımızın kontrol grubuyla karşılaştırıldığında hem somatik hem de nörolojik gelişimde önemli derecede geri kaldıklarını gördük. İmmatürite, kafa içine kanama, mikrosefali, menenjit, sinir sistemine ait hastalıkları arttıran etmenlerdi

Assesment of the patients with broncopulmonary dysplasia (BPD) in terms of somatic growth, pulmonary problems and neurodevelopmental features on long-term follow-up

Aim: This study has been performed for the assessment of postneonatal problems , growth and neuromotor development of the patients with bronchopulmonary displasia (BPD). Material and Method: 31 of the 39 live preterms (79%) who were born in 2003-2004 period were assessed in July 2006. Patients who were diagnosed as BPD were named Group I. The control group was formed as preterms who were born in our hospital after Group I patients, who were close to Group I in terms of weight and gestational age, and who had no history of mechanical ventilation support and was named as Group II. The data of the Group II patients were obtained from the computer database and personal files. Both groups were assessed for their somatic growth and neurodevelopmental profiles at 21-42 months. Results: 20 patients (64,5%) from the Group I had at least one respiratory infection and 6 of them were admitted to the hospital. Microcephaly was found in 38,7% of our patients and 35% were diagnosed as somatic growth retardation on growth follow-up. Denver Developmental Screening Test II was found abnormal in 10 (32%) preterms and 10(32%) patients had deficiency and 3 patients had deficiency plus sequel in modified Amiel-Tison Test. One patient had total blindness. 5 patients (%16)from the Group II were on therapy for multiple respiratory infections and one of them was diagnosed as reactive airway disease. 10% of the patients had somatic growth retardation, 13% had microcephaly when Group II patients were assessed in terms of somatic growth. Two patients (6%) had abnormal Denver II Test, 4 patients (16%) had deficiency in Modified Amiel-Tison Test but none of them had sequel. Conclusions: Presence of BPD is a significant risk factor for disease during the somatic and neurodevelopmental follow-up. As a result of our study we have seen that patients with BPD when compared to control group were significantly retarded in terms of neurological and somatic growth. Immaturity, intraventricular haemorrage, microcephaly, meningitis were important risk factors playing role in the morbidity

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