Minör kafa travmalı pediatrik olgularda ubiquitin cterminal hidrolaz (UCH-L1) kan düzeylerinin tanısal etkinliğinin araştırılması
Date
2020
Authors
Uzun, Ziyaettin
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Çocukluk çağında kafa travmaları acil servise travma ile başvuran hastaların önemli bir kısmını oluşturur. Büyüme dönemindeki çocuklarda kafa travması büyüme ve gelişme basamaklarını etkilemekte, bu nedenle erişkin hastalara göre farklı bir değerlendirme gerekmektedir. Minör kafa travması ile acil servise başvuran hastalarda intrakraniyal yaralanmaları saptamada beyin bilgisayarlı tomografi (BBT) altın standart haline gelmiştir fakat yaygın ve gereksiz kullanımı sağlık giderlerinde artışa ve uzun dönemde radyasyona bağlı risklere sebep olmaktadır. Bu çalışmada minör kafa travması nedeniyle acil servise başvuran 0-18 yaş grubu hastalarda UCH-L1 düzeylerinin BBT’ye alternatif olup olamayacağının araştırılması amaçlanmıştır. Bu çalışma 07.03.2019 ile 27.02.2020 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi (UÜTF) hastanesi acil servisine minör kafa travması ile başvuran 0-18 yaş grubu hastalardan Glaskow Koma Skoru (GKS) 14-15 olup BBT çekilen 60 hasta ve kafa travması dışında minör travma veya medikal nedenler ile acil servise başvuran 20 hasta prospektif olarak değerlendirilerek yapılmıştır. Hastaların yaş, cinsiyet, hastaneye başvuru tarihleri (gün, ay, yıl, saat), GKS, yaralanma bölgesi, yaralanma şekli, travmanın oluş saati, hastaneye geliş saati, tetkik alınma saati ve serum UCH-L1 düzeyleri kayıt altına alınmıştır. Uygun sayıya ulaşıldığında UCH-L1 düzeyi çalışılarak dosyaya eklenmiştir. Minör kafa travmalı pediatrik olgularda UCH-L1 düzeyi kafa travması olan hastalarda kafa travması olmayan hastalara göre istatistiksel olarak anlamlı çıkmasına rağmen BBT bulgusu olan olguları BBT bulgusu olmayan olgulardan ayıramamıştır.
Head trauma in childhood accounts for an important part of patients who present to the emergency departments with trauma. Head trauma affects the stage of growth and development in children during their growing period and therefore should be evaluated differently from adult patients. Brain Computerized Tomography (BCT) has become the gold standart in detecting intracranial injuries in patients presenting with minor head trauma but its wide spread and unnecessary use causes an increase in health expenses and radiation risks in the long term period. Our aim was to investigate whether Ubiquitin Carboxy Terminal Hidraulase L1 (UCH-L1) levels can be an alternative to BCT in patients aged between 0-18 who present to the emergency department with minor head trauma. This study was performed between 01.03.2019 and 27.02.2020 in Uludağ University Medical Faculty (UUMF) Hospital Emergency Department 60 patients within the age group 0-18 years old presenting with minor head trauma and Glacsow Coma Score (GCS) 14-15 who underwent BCT and 20 patients with other minor traumas or other medical reasons were evaluated prospectively. Patient’s age, gender, hospital admission dates (day, month, year, hour), Glasgow Coma Score, injury site, type of injury, time of trauma, hospital arrival time, examination time and serum UCH-L1 levels were recorded. UCH-L1 levels in patients with minor head trauma were higher than other group howewer it was not diagnostic in differentiating the BCT positive patients than BCT negative patients.
Head trauma in childhood accounts for an important part of patients who present to the emergency departments with trauma. Head trauma affects the stage of growth and development in children during their growing period and therefore should be evaluated differently from adult patients. Brain Computerized Tomography (BCT) has become the gold standart in detecting intracranial injuries in patients presenting with minor head trauma but its wide spread and unnecessary use causes an increase in health expenses and radiation risks in the long term period. Our aim was to investigate whether Ubiquitin Carboxy Terminal Hidraulase L1 (UCH-L1) levels can be an alternative to BCT in patients aged between 0-18 who present to the emergency department with minor head trauma. This study was performed between 01.03.2019 and 27.02.2020 in Uludağ University Medical Faculty (UUMF) Hospital Emergency Department 60 patients within the age group 0-18 years old presenting with minor head trauma and Glacsow Coma Score (GCS) 14-15 who underwent BCT and 20 patients with other minor traumas or other medical reasons were evaluated prospectively. Patient’s age, gender, hospital admission dates (day, month, year, hour), Glasgow Coma Score, injury site, type of injury, time of trauma, hospital arrival time, examination time and serum UCH-L1 levels were recorded. UCH-L1 levels in patients with minor head trauma were higher than other group howewer it was not diagnostic in differentiating the BCT positive patients than BCT negative patients.
Description
Keywords
Kafa travması, Acil servis, UCH-L1, Bilgisayarlı tomografi, Head injury, Emergency department, Computerised tomography
Citation
Uzun, Z. (2020). Minör kafa travmalı pediatrik olgularda ubiquitin cterminal hidrolaz (UCH-L1) kan düzeylerinin tanısal etkinliğinin araştırılması. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.