Kemoterapi uygulanan akut lösemili hastalarda nötropenik enterokolit : Hala önemli bir sorun
Küçük Resim Yok
Tarih
2001
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Öz: Nötropenik enterokolit; kemoterapi uygulanan akut lösemili, nötropenik hastalarda periton uyarımı belirtileri, şiddetli karın ağrısı, karında distansiyon, ishal ve ateş ile karakterize çoğunlukla ölümcül seyreden nadir bir komplikasyondur. Tedavisi tartışmalı olmakla beraber vakaların çoğunda cerrahi müdahale için uygun şartlar olmadığından öncelikle medikal takip; peritonit veya perforasyon bulguları gelişenlerde ise cerrahi tedavi önerilmektedir. Bu çalışmada nötropenik eriterokolit gelişen üç akut myeloblastik lösemili hastanın klinik bulguları değerlendirildi. Her üç vakada da ateş, abdominal distansiyon, periton uyarımı belirtileri, asit, hipotansiyon ve organ yetersizliği bulguları gelişmiştir. Hastalar oral gıda alımı kesilip, gastrointestinal dekompresyon, antibiyotik tedavisi, kan ve kan ürünleri desteği, kısmi parenteral beslenme, dengeli sıvı elektrolit tedavisi ile izlenirken bir hastaya klinik ve labaratuvar desteği ile intestinal perforasyon tanısı konmuş ve cerrahi tedavi uygulanmıştır. Vakaların tümü nötropenik enterokolit tanısı konduktan itibaren 4-9 gün içinde kaybedilmiştir. Sonuç olarak lösemili hastalarda kemoterapi uygulamaları sırasında olgular nötropenik enterokolit açısından dikkatle izlenmelidir.
Abstract: Neutropenic enterocolitis is one of the rare fatal complications of Chemotherapy choroctorized by peritoneal irritation signs, severe abdominal pain, abdominal distention, diarrhea, and fever in patients with neutropenia. Because of unfavourable conditions for surgical intervention, treatment of enterocolitis is under debate. However, a primary medical approach is suggested prior to surgical intervention if signs of peritonitis and perforation do not appear. in this study, the clinical signs of three patients with acute myeloblastic leukemia who developed neutropenic enterocolitis was evaluated. in all of the three patients, peritoneal irritation signs, fever, abdominal distention, ascites, hypotension, and signs of organ failure were encountered. Oral nutrition was immediately stopped besides gastrointestinal decom-pression, antibiotic therapy, blood transfusion, partial parenteral nutrition, and fluid-electrolyte balance. However one of the patients was diagnosed as intestinal perforation by clinical and laboratory investigation and finally operated. After having diagnosed as neutropenic enterocolitis, all three cases were lost in the first 4 to 9 days. in conclusion, Chemotherapy applied patients with acute leukemia showed be carefully evaluated for neutropenic enterocolitis.
Abstract: Neutropenic enterocolitis is one of the rare fatal complications of Chemotherapy choroctorized by peritoneal irritation signs, severe abdominal pain, abdominal distention, diarrhea, and fever in patients with neutropenia. Because of unfavourable conditions for surgical intervention, treatment of enterocolitis is under debate. However, a primary medical approach is suggested prior to surgical intervention if signs of peritonitis and perforation do not appear. in this study, the clinical signs of three patients with acute myeloblastic leukemia who developed neutropenic enterocolitis was evaluated. in all of the three patients, peritoneal irritation signs, fever, abdominal distention, ascites, hypotension, and signs of organ failure were encountered. Oral nutrition was immediately stopped besides gastrointestinal decom-pression, antibiotic therapy, blood transfusion, partial parenteral nutrition, and fluid-electrolyte balance. However one of the patients was diagnosed as intestinal perforation by clinical and laboratory investigation and finally operated. After having diagnosed as neutropenic enterocolitis, all three cases were lost in the first 4 to 9 days. in conclusion, Chemotherapy applied patients with acute leukemia showed be carefully evaluated for neutropenic enterocolitis.
Açıklama
Anahtar Kelimeler
Kaynak
Türk Hematoloji Onkoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
11
Sayı
1
Künye
SARI R,ÖZEN S,SEVİNÇ A,AYDOĞDU İ (2001). Kemoterapi uygulanan akut lösemili hastalarda nötropenik enterokolit : Hala önemli bir sorun. Türk Hematoloji Onkoloji Dergisi, 11(1), 13 - 18.
