Sirozlu hastada albumin tedavisinin etkinliği / Effectiveness of albumin therapy in cirrhosis patient
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Tarih
2020
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İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Siroz, kronik karaciğer hastalıklarının seyrinde görülen karaciğer parankiminin kaybolduğu, bağ dokusunun arttığı, rejenarasyon nodüllerinin oluştuğu kronik diffuz bir karaciğer hastalığıdır. İnsan serum albümini ise karaciğerde sentezlenmektedir ve plazma onkotik basıncından sorumlu ana plazma proteinidir. Albümin fonksiyonunun hacim genişlemesinin ötesindeki faydalı rolü gelişen bir alandır ve hastalık süreçlerini modüle etmekteki rolünü anlamak için Sirozlu hastalarda HAS kullanımı, sirozun komplikasyonlarından korunmak için veya tedavi için kullanımı ile ilgili çalışmalar devam etmektedir. Bu nedenle tezimizde konu olarak HAS'nin sirozlu hastada infüzyon tedavisi ile etkinliğini araştırdık. Materyal ve Metodlar: İnönü Üniversitesi Turgut Özal Tıp Merkezi Gastroentereloji Bilim Dalı'na herhangi bir nedenle yatış yapılarak izlenen ve karaciğer sirozu tanısı olan ve 3 gün arka arkaya 190-210 g/L protein ve bu proteinin %95'i albumin olan ilaçlardan günde 2x1 olacak şekilde alan hastalar retrospektif olarak incelendi. Bulgular: Çalışmaya 30 hasta dahil edildi. Başlangıç serum albumin düzeyi ortalaması 1.8 gr/dl olan 30 hastanın tedavi sonrasında ki albumin seviyeleri ortalama 2.6 gr/dl düzeylerine 7. günde ulaşmış ve 30 gün bu seviyelerde seyretmiştir. Olguların başlangıç değeri ile 7. gün değerleri arasındaki fark istatistiksel olarak anlamlı bulundu (p<0,000). 7. günden daha sonraki takiplerinde albumin değerlerinin istatistiksel olarak anlamlı düşmediği gözlendi (p=0,42). Sonuç: Albumin infüzyonunun sirozlu hastada özellikle hasta grubumuzda (Child skoru yüksek) serum albumin düzeylerine faydası olduğu tespit edilmiştir. Bu açıdan bakınca özellikle transplant bekleyen child skoru yüksek hastalar, HAS tedavisi ile desteklenerek sirozun komplikasyonları azaltılabilir. Çünkü bu hastalar nakil sırası beklerken enfeksiyon gibi komplikasyonlardan dolayı nakilleri gecikmekte ya da exitus olmaktadırlar. Anahtar Kelime: Siroz, Human serum albumin; Human albumin solüsyonu, Karaciğer nakli.
İntroduction: Human serum albumin is synthesized in the liver and is the main plasma protein responsible for plasma oncotic pressure. The beneficial role of albumin function beyond volume expansion is an evolving area. Studies on the use of HAS in patients with cirrhosis, for prevention of cirrhosis complications or for treatment are ongoing. Therefore, we investigated the efficacy of HAS with infusion therapy in patients with cirrhosis as a subject in our thesis. Materials and Methods: Patients with liver cirrhosis who were admitted to the Gastroenterology Department of İnönü University Turgut Özal Medical Center and followed up were evaluated. The patients who received 3 consecutive days (2x1 per day) 190-210 g / L protein and 95% of this protein, were retrospectively analyzed. Results: Thirty patients were included in the study. In 30 patients with a mean baseline serum albumin level of 1.8 gr/dl, albumin levels after treatment reached an average of 2.6 gr/dl on the 7th day. and it remained at these levels for 30 days. Findings were statistically significant (p <0.000). After the 7th day, it was observed that Albumin values did not decrease statistically significantly (p = 0.42). Discussion: Albumin infusion was found to be beneficial for serum albumin levels in the patient with child score cirrhosis. From this point of view, complications of cirrhosis can be reduced by supporting HAS treatment, especially in patients awaiting transplant. Because these patients are delayed transmission due to such complications as infection or transmission waiting queue are being died. Key words: Cirrhosis, Human serum albumin; Human albumin solution, Liver Transplantation.
İntroduction: Human serum albumin is synthesized in the liver and is the main plasma protein responsible for plasma oncotic pressure. The beneficial role of albumin function beyond volume expansion is an evolving area. Studies on the use of HAS in patients with cirrhosis, for prevention of cirrhosis complications or for treatment are ongoing. Therefore, we investigated the efficacy of HAS with infusion therapy in patients with cirrhosis as a subject in our thesis. Materials and Methods: Patients with liver cirrhosis who were admitted to the Gastroenterology Department of İnönü University Turgut Özal Medical Center and followed up were evaluated. The patients who received 3 consecutive days (2x1 per day) 190-210 g / L protein and 95% of this protein, were retrospectively analyzed. Results: Thirty patients were included in the study. In 30 patients with a mean baseline serum albumin level of 1.8 gr/dl, albumin levels after treatment reached an average of 2.6 gr/dl on the 7th day. and it remained at these levels for 30 days. Findings were statistically significant (p <0.000). After the 7th day, it was observed that Albumin values did not decrease statistically significantly (p = 0.42). Discussion: Albumin infusion was found to be beneficial for serum albumin levels in the patient with child score cirrhosis. From this point of view, complications of cirrhosis can be reduced by supporting HAS treatment, especially in patients awaiting transplant. Because these patients are delayed transmission due to such complications as infection or transmission waiting queue are being died. Key words: Cirrhosis, Human serum albumin; Human albumin solution, Liver Transplantation.
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CENGİZ, AYŞE N.(2020). Sirozlu hastada albumin tedavisinin etkinliği / Effectiveness of albumin therapy in cirrhosis patient, İnönü Üniversitesi / Tıp Fakültesi / İç Hastalıkları Ana Bilim Dalı.
