2000-2009 tarihleri arasında Uludağ Üniversitesi Tıp Faküitesi Gastroenteroloji Bilim Dalına başvuran ülseratif kolit tanılı hastaların retrospektif değerlendirilmesi
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Date
2010
Authors
İbanoğlu, Mahmut Serbülent
Journal Title
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Publisher
Uludağ Üniversitesi
Abstract
Çalışmamızda Uludağ Üniversitesi Gastroenteroloji Bilim Dalı tarafından 2000-2009 yılları arasında takip edilen 105 ülseratif kolitli hasta retrospektif olarak incelendi. Hastaların klinik bulguları, klinik şiddeti, hastalığın yaygınlığı, hastalık seyri sırasında ortaya çıkankomplikasyonlar, uygulanan medikal tedavi ve hastalığın seyri hakkında bilgiler değerlendirilerek analiz edildi.Ülseratif kolitli vakalarımızın epidemiyolojik verileri incelendiğinde hastaların 63'ünün (%60) erkek, 42'sinin (%40) bayan olduğu saptandı. Erkek bayan oranı ise 1.5/1 idi. Hastaların 27 (%29,7) sinde sigara kullanım öyküsü mevcut iken, hastaların hiçbirisinde oral kontraseptif kullanımı ve birinci derece yakınlarında ülseratif kolit öyküsü saptanmamıştı. Hastaların 30'u (%33) lise, 23'ü (%25,3) üniversite eğitimi almışken 4'ü (%4,4) okur yazar değildi. Hastaların büyük çoğunluğu 89 (%84,8)'u evli iken 12 hasta (%11,4) bekar idi. Ülseratif kolitli hastalarımızda en sık gözlenen şikayetlerin; karın ağrısı 86 olguda (%92,5), kanlı diare 90 olguda (%77), mukuslu dışkılama 59 olguda (%62) olduğu gözlendi. Hastaların 35'inde (%38) ateş, 22'sinde (%24,7) kilo kaybı, 5'inde (%5,4) kabızlık mevcuttu. Yapılan diğer çalışmalarda ülseratif kolitin klinik bulguların görülme sıklığı da benzer oranlarda tespit edilmiştir.Hastalığın klinik şiddeti ?Truelove-Witts? kriterlerine göre; 37 hasta (%36,6) hafif şiddetli, 36 hasta (%35,6) orta şiddetli, 28 hasta (%27,7) ağır şiddetli ülseratif kolit olarak değerlendirildi. Hastalığın yaygınlığı yapılan kolonoskobik işlemde tutulan kolon bölgesine göre sınıflandırıldı. Distal kolit 37 hastada (%36,3), sol kolit 17 hastada (%16,7), yaygın kolit 19 hastada (%18,9), pankolit 29 hastada (%28,4) gözlemlendi. Hastalarımızın tümüne ASA preparatı uygulanmışken, 45 hastaya (%44,1) steroid, 35 hastaya (%33,7) 5-ASA ,azatiopürin ve steroid kombine tedavisi uygulanmıştı. 3 hastaya (%2,9) ise siklosporin tedavisi uygulanmıştı. Ülseratif kolitli hastalarımızda en sık gözlenen komplikasyonların 5 olguda (%4,9) perforasyon ve 4 olguda (%3,9) karsinom olduğu gözlemlenmiştir.Hepatosteatoz, cilt ve eklem bulguları en sık gözlenen ekstraintestinal tutulumlar olarak saptandı. Hastalarımızda hastalığın seyrinin 71 olguda (%69,2) kronik intermittant hastalık, 13 olguda (%12,4) kronik devamlı hastalık, 5 olguda (%4,8) akut fulminant hastalık olarak tespit edildi. 6 hastanın (%5,7) sadece tek atak geçirdiği ve 1 hastanın ülseratif kolit ile ilişkili perforasyon komplikasyonu ile öldüğü 2 hastanın ise ülseratif kolitle ilişkili olmayan nedenlerle öldüğü saptandı.
In our study, 105 ulcerative colitis patients followed by Gastroenterology Department of Uludağ University Medical Faculty during 2000- 2009 years researced with retrospective method. Clinical symptoms and severities of patients, prevelance of disease, complications occurred during disease, applied convenient medical treatments and informations about process of disease are considered and analyzed. When epidemiologic datum of our cases with ulcerative colitis are examined it was determined that; 63 patients (63%) male, 42 patients (40%) female. Male/Female ratio was 1,5/1. 27 patients (29.7%) were smoker, none of the patients had used oral contraseptive pills and had not any first degree relations with ulcerative colitis. 30 patients (33%) were highschool, 23 patients (23.3%) were university educated and 4 (4.4%) of the patients were non literated. Majority of patients 89 (84.8%) were married, 12 (11.4%) patients were single status. The most common complainings in our patients with ulcerative colitis were; stomach ache in 86 cases (92.5%), diarrhea with hematochezia in 90 cases (77%), defecation including mucus in 59 cases (62%) had been observed. 35 of the patients (38%) had had fever, 22 of patients (24.7%) had loss of wieght, 5 of patients (5.4%) had constipation existed. In other researches it had determined that prevalences of clinical symptoms of ulcerative colitis were similar. Clinical severity of disease evaluated according to "Truelove-Witts" criteria; 37 patients had (35.6%) low severity, 36 patients (35.6%) medium severity, 28 patients (27.7%) high severity ulcerative colitis. Extent of disease classified according to the zones of colon retained in colonoscopic operation. Distal colit in 37 patients (36.3%), left colit in 17 patients (16.7%), extensive colit in 19 patients (18.9%), pancolit in 29 patients (28.4%) had observed. 5-ASA had applied in all patients, steroid applied in 45 patients (44.1%), 5- ASA, azatiopurine and steroid combination treatment had applied in 35 patients (33.7%). As for 3 patients (2.9%) cyclosporine treatment had applied. The most comman complications observed in our patients with ulserative colit; in 5 cases (4.9%) perforation and in 4 cases (3.9%) carcinoma. Hepatosteatosis, skin and joint symptoms had determined as the most common ekstraintestinal eclipses. Process of disease in our patients had determined as; in 71 cases (69.2%) chronic intermittant disease, in 13 cases (12.4%) chronic continuous disease, in 5 cases (4.8%) acute fulminant disease. 6 patients (5.7%) had only one attack and 1 patient died because of perforation complication associated with ulcerative colitis, as for 2 patients died because of other reasons not associated with ulcerative colitis.
In our study, 105 ulcerative colitis patients followed by Gastroenterology Department of Uludağ University Medical Faculty during 2000- 2009 years researced with retrospective method. Clinical symptoms and severities of patients, prevelance of disease, complications occurred during disease, applied convenient medical treatments and informations about process of disease are considered and analyzed. When epidemiologic datum of our cases with ulcerative colitis are examined it was determined that; 63 patients (63%) male, 42 patients (40%) female. Male/Female ratio was 1,5/1. 27 patients (29.7%) were smoker, none of the patients had used oral contraseptive pills and had not any first degree relations with ulcerative colitis. 30 patients (33%) were highschool, 23 patients (23.3%) were university educated and 4 (4.4%) of the patients were non literated. Majority of patients 89 (84.8%) were married, 12 (11.4%) patients were single status. The most common complainings in our patients with ulcerative colitis were; stomach ache in 86 cases (92.5%), diarrhea with hematochezia in 90 cases (77%), defecation including mucus in 59 cases (62%) had been observed. 35 of the patients (38%) had had fever, 22 of patients (24.7%) had loss of wieght, 5 of patients (5.4%) had constipation existed. In other researches it had determined that prevalences of clinical symptoms of ulcerative colitis were similar. Clinical severity of disease evaluated according to "Truelove-Witts" criteria; 37 patients had (35.6%) low severity, 36 patients (35.6%) medium severity, 28 patients (27.7%) high severity ulcerative colitis. Extent of disease classified according to the zones of colon retained in colonoscopic operation. Distal colit in 37 patients (36.3%), left colit in 17 patients (16.7%), extensive colit in 19 patients (18.9%), pancolit in 29 patients (28.4%) had observed. 5-ASA had applied in all patients, steroid applied in 45 patients (44.1%), 5- ASA, azatiopurine and steroid combination treatment had applied in 35 patients (33.7%). As for 3 patients (2.9%) cyclosporine treatment had applied. The most comman complications observed in our patients with ulserative colit; in 5 cases (4.9%) perforation and in 4 cases (3.9%) carcinoma. Hepatosteatosis, skin and joint symptoms had determined as the most common ekstraintestinal eclipses. Process of disease in our patients had determined as; in 71 cases (69.2%) chronic intermittant disease, in 13 cases (12.4%) chronic continuous disease, in 5 cases (4.8%) acute fulminant disease. 6 patients (5.7%) had only one attack and 1 patient died because of perforation complication associated with ulcerative colitis, as for 2 patients died because of other reasons not associated with ulcerative colitis.
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Keywords
Ülseratif kolit, Klinik seyir, Klinik bulgular, Ulcerative colitis, Clinical course, Clinical findings
Citation
İbanoğlu, M. S. (2010). 2000-2009 tarihleri arasında Uludağ Üniversitesi Tıp Faküitesi Gastroenteroloji Bilim Dalına başvuran ülseratif kolit tanılı hastaların retrospektif değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.