Öz:Bu çalışmada, 1998-2003 yılları arasında kliniğimizde izlenen 63 pulmoner embolili hastanın genel özellikleri geriye dönük olarak incelendi. Olguların yaş ortalaması 49.4 ± 16.8 yıl olup, 35 (%55.6)'i kadın, 28 (%44.4)'i erkek idi. Kırk beş (%71.4) hastada risk faktörü mevcuttu, bunların 5 (%7.9)'inde genetik risk faktörü tespit edildi. Göğüs ağrısı (%79.4), nefes darlığı (%74.6) ve öksürük (%41.3) en sık olan yakınmalardı. Olguların radyolojik bulguları sırasıyla, plevral sıvı (n= 22), diyafram yükselmesi (n= 14), parankim infiltrasyonu (n= 12) şeklindeyken, 16 (%25.4) olgunun grafisi normaldi. Yirmibeş (%39.7) olgunun elektrokardiyografi (EKG)'sinde sinüs taşikardisi, 23 (%36.5) olgunun ekokardiyografi (EKO)'sinde sağ kalp yetmezliğine ait bulgular saptandı. Olguların %63.5'ine alt ekstremite venöz Doppler incelemesi ya-pıldı, 20 (%31.7) olguda derin ven trombozu (DVT) tespit edildi. Arter kan gazı analizlerine göre 21 (%33.3) hastada hi-poksemi, 31 (%49.2) hastada hipokapni, 34 (%54) hastada solunumsal alkaloz tespit edildi. Perfüzyon sintigrafisi yapılan 47 olgunun 33 (%70.2)'ünde yüksek olasılıklı pulmoner emboli ile uyumlu perfüzyon defekti saptandı. Ellialtı (%88.9) olguya heparin ve warfarinden oluşan antikoagülan tedavi uygulanırken, 2 (%3.2) olguya streptokinazdan oluşan trombolitik tedavi uygulandı. Üç (%4.8) olguya da vena kava inferiora filtre takıldı.
Abstract:We retrospectively analysed 63 pulmonary embolism cases who had been diagnosed in our clinics between 1998-2003. The mean age of the patients was 49.4 ± 16.8 years, and 35 (55.6%) of them were female and the others were male (44.4%). While 5 (7.9%) patients had genetic risk factors for pulmonary embolism, there were predisposing factors in 45 (71.4%) patients. The main complaints were chest pain (79.4%), dsypnea (74.6%) and cough (41.3%). In radiological examinations, pleural effusion (n= 22), elevation of diaphragm (n= 14), parenchymal infiltration (n= 12) were the pre-dominant features, in 16 (25.4%) patients X-rays were normal. Twenty-five (39.7%) patients had sinus tachycardia, and 23 (36.5%) patients had right hearth failure on echocardiography. Doppler examination of lower extremities was done in 63.5% of the patients, and in 20 (31.7%) cases deep venous thrombosis was detected. In arterial blood gases samp-les, 21 (33.3%) patients had hypoxemia, 31 (49.2%) patients were hypocapnic and 34 (54%) patients had respiratory alkalosis. High-probability lung scan defect was found in 33 (70.2%) of 47 patients from whom we obtained ventilation-perfusion lung scan. While standart heparin and warfarin treatment was instituted in 56 (88.9%) patients, thrombolytic therapy (streptokinase) was given to 2 (3.2%) patients. Vena cava filter placement was performed in 3 (4.8%) patients.
