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DOI:
https://doi.org/10.5281/zenodo.7728507Anahtar Kelimeler:
englishÖzet
Amaç: Respiratuar sinsisyal virüs (RSV) bronşiyoliti tedavi sürecinde çocukların demografik ve klinik özelliklerini ve verilen tedavilerin türlerini ve sıklıklarını değerlendirmek.
Gereç ve Yöntem: Kasım 2017-Şubat 2018 tarihleri arasında 63 çocuğa (39 kız, 24 erkek; ort. yaş 8.7 ay; dağılım 2-24 ay) RSV'ye bağlı akut bronşiyolit tanısı kondu. Mikrobiyolojik tanı, İmmünokromatografik yöntemle ile RSV antijenleri tespit edilerek yapıldı. Risk faktörleri, başvuru anındaki semptom ve bulgular, laboratuvar ve radyografik bulgular ve tedavi yöntemleri gibi bilgiler retrospektif olarak tarandı.
Bulgular: Elli üç hasta (%84,1) 12 aydan küçüktü. Doğum ağırlıkları 1600 ile 4250 gr arasında ve gebelik yaşları 31 ile 41 hafta arasındaydı. 11 hastada (%17,5) prematüre, 17 hastada (%27) ek hastalık saptandı. 34 (%54) hastada yatış gerekti ve bunların üçü (%4,8) yoğun bakıma alındı. Aşağıdaki tedavi modaliteleri belirtilen durumlarda daha sık kullanılmıştır: çoklu bronkodilatörler, komorbid durumlar (%35,3) ve takipne (%29,7) varlığında; inhale steroid tedavisi, hipoksemi (%90.9) ve takipne (%89.2) varlığında; sistemik steroid tedavisi, takipne (%40.5) varlığında; intravenöz sıvı tedavisi, takipne (%78.4) varlığında; antibiyoterapi, komorbid durum (%76,5) varlığında daha sık kullanılmıştır. Takipne (%83,8) ve hiperkarbi (%83,3) olan hastalarda hastaneye yatış daha sık gerekmiştir. Tedavi yöntemleri, komorbidite, yaş <12 ay ve takipnesi olan ve olmayan hastalar arasında anlamlı farklılık gösterdi. (p<0.05).
Sonuç: Komorbid durumların varlığı ve takipne, tedavi ihtiyacının belirlenmesinde kritik bir rol oynuyor gibi görünmektedir. Takipne bir semptom olarak hastaneye yatış ihtiyacını öngörmenin yanı sıra, çoklu bronkodilatatör tedavisi, steroid tedavisi ve antibiyotik tedavisini öngörme konusunda da yardımcı olabilir. Takipne, hipoksemi, komorbidite ve radyografik infiltrasyonun varlığı, antibiyotik ihtiyacı ile ilişkili görünmektedir. Ayrıca akciğer grafisinde infiltrasyon varlığı, asidoz, hipoksemi ve hiperkarbi de hastaneye yatış göstergesidir.
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Referanslar
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