Özet
AmaçPostoperatif solunum komplikasyonları (PSK) yukarı batın girişimlerinde aşağı batın girişimlerine göre yüksek bir oranda görülür. Bu komplikasyonlardan biriside plevral efüzyonlardır. Bu çalışmada yukarı batın ameliyatlarından sonra gelişen plevral efüzyonun sıklığı ve nedenleri, plevral efüzyon gelişen olgularda postoperatif solunum fonksiyonu ve arteryel kan gazı değişiklikleri literatür eşliğinde tartışılmıştır.
Gereç ve YöntemlerYukarı batın ameliyatı olan 148 olgudan plevral efüzyon gelişmiş 47 (%31.
Anahtar KelimelerBatın, Cerrahi, Plevral Efüzyon.
Abstract AimPostoperative pulmonary complications, following upper abdominal surgery, occur at a rate which is higher, than lower abdominal surgery. One of these complications is pleural effusion. In this study, the frequency and causes of pleural effusions and the changes of the blood gas values and pulmonary functions of the patients with pleural effusions, occured after upper abdominal surgery are discussed in the accompaniment of the literature.
Material and Methods148 patients to whom upper adominal surgery is performed and in 47 of these patients pleural effusion is developed (31.75%) , were examined restrospectivitely. Preoperative and postoperative pulmonary function tests (PFT) and arterial blood gas (ABG) results and the blood proteins, albumin values were recorded. The anesthesia type, the surgery properties, involving type of surgery and the surgical incision were determined.
ResultsPleural effusion is detected bilaterally in 8 patients (17:02), at the right side in 21 patients (44.69%) ,and at the left side in 18 patients (38.29%).The 40.42% (19 cases) of the patients who has pleural effusion in the postoperative period, had liver and gallbladder surgery, the %23.41 (11 cases) had spleen and pancreas surgery and the %36.17 (17 cases) had the other surgical procedures.
ConclusionsWhile the upper abdominal surgery, impairment of the integrity of the diaphragm's peritoneum that covers the abdominal cavity where there is a highliquid pressure, may cause the liquid transition to the pleural space that has a negative pressure. Hypoalbuminemia and hipoproteinemia, that will occur due to the changes of oral intake and diet regulation in the postoperative period, may cause a reason for the pleural effusion. For this reason, doctors who performed these surgery procedures, should not ignore this complication, in the period of postoperative follow-ups of the patients.