Çocuk hematoloji kliniği ve polikliniğinde tedavi gören hastaların katater komplikasyonlarının retrospektif incelenmesi
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Date
2021
Authors
Yörük, Gülce
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada pediatrik lösemi hastalarına takılan kalıcı santral venöz kataterlerin (SVK) kullanımı sırasında gelişen komplikasyonlar, risk faktörleri ve komplikasyonların yönetiminin değerlendirilmesi amaçlanmıştır. Uludağ Üniversitesi Tıp Fakültesi Çocuk Hematoloji Bilim Dalı’nda Ocak 2010 - Ocak 2018 tarihlerinde akut lösemi tanısı alan veya relaps olan 0-18 yaş arasındaki 262 hastaya Çocuk Cerrahisi Anabilim Dalı tarafından bir veya birden çok defa yerleştirilen 310 SVK’de gelişen komplikasyonlar; port ve Hickman katater takılan gruplar ile komplikasyon olan ve olmayan gruplar belirlenen parametreler açısından karşılaştırmalı incelenmiştir. Toplam 198 hastada akut lenfoblastik lösemi, 64 hastada akut myeloblastik lösemi tanısı mevcut iken 72 hasta relaps lösemi nedeniyle tedavi almaktaydı. İzlemde 221 hastaya bir defa, 34 hastaya iki defa, 7 hastaya üç defa SVK takılmıştır. Toplamda 310 SVK’de (n=250 port, n=60 Hickman katater) 225.296 katater günü değerlendirilmiştir. Çalışmada erkek cinsiyet (%59,2) daha fazladır. Medyan yaş 58,2 (3,4-216,8) aydır. Çalışmadaki 118 hastaya takılan 136 SVK’de (n=100 port, n=36 Hickman katater) eş zamanlı veya farklı dönemlerde tekrarlayan komplikasyonlarında eklenmesiyle 157 komplikasyon gelişmiştir. Enfeksiyöz komplikasyon 91 (%58), vasküler komplikasyon 35 (%22,3), cerrahi komplikasyon 19 (%12,1) ve mekanik komplikasyon 12 (%7,6) defa görülmüştür. En sık enfeksiyöz nedene bağlı olmak üzere toplam 78 SVK (%57,3) çıkarılmıştır. SVK kümülatif kalım süresi medyan 661,5 gün (1-2636 gün)’dür. Katater komplikasyonuna bağlı 5 (%1,9) ölüm görülmüştür. SVK kullanımı hastaların hayat kalitesinde önemli bir rahatlık sağlamışken SVK uygulanması veya kullanılması sırasında gelişen komplikasyonlar önemli bir morbidite ve mortalite sebebi olabilmektedir. Multidisipliner tedavi protokolleri ve profesyonel ekipler sayesinde komplikasyonların azaltılabileceği düşünülmektedir.
In this study we aimed to asses the complications which occurs during usage of long term (permanent) central venous catheter (CVC) in pediatric leukaemia patients, its risk factors and complication management. Complications that occured at 310 CVC which was inserted once or more by Department of Pediatric Surgery to the 262 patients at age 0-18 who diagnosed with acute leukaemia or relapse of leukaemia in between January 2010 - January 2018 in Uludag University Department of Pediatric Hematology; port and Hickman catheter inserted groups with groups which has complications and which has not were comparatively analyzed for the determined parameters. 198 patients had acute lymphoblastic leukaemia, 64 patients diagnosed with acute myeloblastic leukaemia, 72 patient were under treatment because of relapsing leukaemia. In follow up 221 patients once, 34 patients twice, 7 patients three times inserted with CVC. In total 310 CVC (n=250 port, n=60 Hickman catheter) 225.296 catheter days were evaluated. In study male gender (59,2%) were more than female. Median age is 58,2 (3,4 - 216,8) months. In study 136 CVC (n=100 port, n=36 Hickman catheter) which were inserted 118 patients developed 157 recurring complications that occur simultaneously or in different times. Infectious complications were seen 91 times (58%), vasculer complications were seen 35 times (22,3%), surgical complications were seen 19 times (12,1%) and mechanical complications were seen 12 times (7,6%). 78 CVC (57,3%) were removed mostly because of infectious causes. CVC cumulative staying time is median 661,5 days (1-2636 days). 5 deaths were seen due to catheter complication. CVC use provided significant improve of patients' quality of life but the complications which occurs during insertion or usage could become an important morbidity and mortality reason. It is thought that because of iv multidiscilinary treatment protocols and professional teams, complications could be reduced.
In this study we aimed to asses the complications which occurs during usage of long term (permanent) central venous catheter (CVC) in pediatric leukaemia patients, its risk factors and complication management. Complications that occured at 310 CVC which was inserted once or more by Department of Pediatric Surgery to the 262 patients at age 0-18 who diagnosed with acute leukaemia or relapse of leukaemia in between January 2010 - January 2018 in Uludag University Department of Pediatric Hematology; port and Hickman catheter inserted groups with groups which has complications and which has not were comparatively analyzed for the determined parameters. 198 patients had acute lymphoblastic leukaemia, 64 patients diagnosed with acute myeloblastic leukaemia, 72 patient were under treatment because of relapsing leukaemia. In follow up 221 patients once, 34 patients twice, 7 patients three times inserted with CVC. In total 310 CVC (n=250 port, n=60 Hickman catheter) 225.296 catheter days were evaluated. In study male gender (59,2%) were more than female. Median age is 58,2 (3,4 - 216,8) months. In study 136 CVC (n=100 port, n=36 Hickman catheter) which were inserted 118 patients developed 157 recurring complications that occur simultaneously or in different times. Infectious complications were seen 91 times (58%), vasculer complications were seen 35 times (22,3%), surgical complications were seen 19 times (12,1%) and mechanical complications were seen 12 times (7,6%). 78 CVC (57,3%) were removed mostly because of infectious causes. CVC cumulative staying time is median 661,5 days (1-2636 days). 5 deaths were seen due to catheter complication. CVC use provided significant improve of patients' quality of life but the complications which occurs during insertion or usage could become an important morbidity and mortality reason. It is thought that because of iv multidiscilinary treatment protocols and professional teams, complications could be reduced.
Description
Keywords
Port, Hickman, Pediatrik hematoloji, Komplikasyon, Pediatric hematology, Complication
Citation
Yörük, G. (2021). Çocuk hematoloji kliniği ve polikliniğinde tedavi gören hastaların katater komplikasyonlarının retrospektif incelenmesi. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.