Akci\u011fer dokusu i\u00e7ine veya d\u0131\u015far\u0131 do\u011fru olan Hava s\u0131z\u0131nt\u0131lar\u0131 en s\u0131k, yenido\u011fan d\u00f6neminde g\u00f6r\u00fcl\u00fcr. Akci\u011feri \u00e7evreleyen zarlar\u0131n aras\u0131na hava ka\u00e7mas\u0131 (pn\u00f6motoraks), akci\u011ferdeki damar ve hava bo\u015fluklar\u0131n\u0131n aras\u0131na hava s\u0131zmas\u0131 (interstisyel amfizem), akci\u011fer ile g\u00f6\u011f\u00fcs bo\u015flu\u011fu aras\u0131na hava ka\u00e7mas\u0131 (pn\u00f6momediastinum) ve akci\u011fer ile kalp zar\u0131 aras\u0131na hava s\u0131zmas\u0131 (pn\u00f6moperikardium) \u015feklinde g\u00f6r\u00fclen formlar\u0131 vard\u0131r. Bu tablolar\u0131n hepsi yenido\u011fanlarda ani k\u00f6t\u00fcle\u015fmeye yol a\u00e7ar ve acil tedavi gerektirir.<\/p>\n
Hava ka\u00e7aklar\u0131n\u0131n esas nedeni akci\u011ferdeki keseciklere hava girip ve \u00e7\u0131karken Havan\u0131n fazla tutulmas\u0131 nedeniyle keseciklerin a\u015f\u0131r\u0131 gerilmesi ve patlamas\u0131d\u0131r. K\u00fc\u00e7\u00fck hava yollar\u0131n\u0131n t\u0131kanmas\u0131 sonucuda geli\u015febilir.<\/p>\n
PN\u00d6MOTORAKS<\/p>\n
En s\u0131k rastlanan form olup yeni do\u011fan d\u00f6neminde hayat\u0131n di\u011fer d\u00f6nemlerine g\u00f6re daha s\u0131k g\u00f6r\u00fcl\u00fcr. T\u00fcm yeni do\u011fanlarda yap\u0131lan ara\u015ft\u0131rmalarda %1 oran\u0131nda saptan\u0131rken bunlar\u0131n %10’u hastada klinik olarak bulgu verir.\u00a0 Altta yatan bir akci\u011fer hastal\u0131\u011f\u0131 varsa %4, hasta solunum cihaz\u0131nda ise %26-35 oran\u0131nda g\u00f6r\u00fclebilir.<\/p>\n
Her iki akci\u011ferde g\u00f6r\u00fclebildi\u011fi gibi vakalar\u0131n \u00e7o\u011funda tek tarafl\u0131d\u0131r.<\/p>\n
Do\u011fumdan hemen sonra ilk nefes almada olu\u015fan y\u00fcksek Bas\u0131n\u00e7 nedeniyle olabildi\u011fi gibi solunum cihaz\u0131nda olan bebeklerde hava keseciklerindeki ani bas\u0131n\u00e7 de\u011fi\u015fiklikleri nedeniyle ve nadiren ailesel olarak geli\u015febilir.<\/p>\n
K\u00fc\u00e7\u00fck olan hava ka\u00e7aklar\u0131 \u00e7o\u011fu zaman hastada bulgu vermez. B\u00fcy\u00fck olanlarda solunum s\u0131k\u0131nt\u0131s\u0131n\u0131n b\u00fct\u00fcn belirtileri g\u00f6r\u00fcl\u00fcr. \u00c7ok b\u00fcy\u00fck olan hava ka\u00e7aklar\u0131nda hastada \u015fok tablosu geli\u015febilir. Solunum hastal\u0131\u011f\u0131 olan bebeklerin durumunda ani k\u00f6t\u00fcle\u015fme olursa hava ka\u00e7a\u011f\u0131ndan \u015f\u00fcphelenilmelidir. Akci\u011ferin tek taraf\u0131nda ka\u00e7ak varsa bu tarafta solunum sesleri al\u0131namaz.<\/p>\n
Tan\u0131 akci\u011fer r\u00f6ntgeni ile konulur.<\/p>\n
Tedavi; k\u00fc\u00e7\u00fck ve bulgu vermeyen hava ka\u00e7aklar\u0131nda tadavi gerekmez. Hafif bulgular\u0131 olan hastalara Oksijen verilerek izlem yap\u0131l\u0131r. Daha b\u00fcy\u00fck ve bulgu veren hava ka\u00e7aklar\u0131nda ise enjekt\u00f6r ucuna tak\u0131lan kal\u0131n bir i\u011fne ile hava bo\u015falt\u0131l\u0131r ve t\u00fcp tak\u0131larak havan\u0131n tam bo\u015falmas\u0131 sa\u011flan\u0131r.\u00a0 T\u00fcp tak\u0131ld\u0131ktan sonra 72-96 Saat b\u0131rak\u0131lmal\u0131 ve t\u00fcp \u00e7\u0131kar\u0131lmadan kapat\u0131larak tekrar hava dolup dolmad\u0131\u011f\u0131 izlenmelidir.<\/p>\n
Akci\u011feri \u00e7evreleyen zarlarda b\u00fcy\u00fck y\u0131rt\u0131k varsa cerrahi olarak d\u00fczeltme yap\u0131l\u0131r.<\/p>\n
Uygun tedavi ile hastalar\u0131n \u00e7o\u011funlu\u011fu d\u00fczelir. Erken do\u011fan ve altta yatan ba\u015fka hastal\u0131\u011f\u0131 olan bebeklerde seyir k\u00f6t\u00fc olabilir.\u00a0\u00a0<\/p>\n
AMF\u0130ZEM<\/p>\n
Hava kesecikleri ve k\u00fc\u00e7\u00fck hava yollar\u0131ndaki havan\u0131n akci\u011ferin i\u00e7ine s\u0131zmas\u0131 sonucu g\u00f6r\u00fclen ve r\u00f6ntgen ile tan\u0131 konan bir durumdur. S\u0131kl\u0131kla bebek Yeni do\u011fan\u0131n Solunum Yetmezli\u011fi tan\u0131s\u0131 ile izlenirken geli\u015febilir. Ayr\u0131ca aspirasyon sendromlar\u0131nda (bebe\u011fin do\u011fum s\u0131ras\u0131nda kakas\u0131n\u0131 akci\u011ferlerine ka\u00e7\u0131rmas\u0131 sonucu geli\u015fir) da amfizem g\u00f6r\u00fclebilir.<\/p>\n
Hastada ciddi solunum yetmezli\u011fi vard\u0131r. \u0130lk 24 Saate amfizem geli\u015fen erken do\u011fan premat\u00fcre bebeklerde \u00f6l\u00fcm oran\u0131 y\u00fcksektir. Bulgular\u0131n \u015fiddeti ve tedaviye cevap etkilenen akci\u011fer alan\u0131n\u0131n b\u00fcy\u00fckl\u00fc\u011f\u00fcne ba\u011fl\u0131d\u0131r. Tedavide hasta solunum cihaz\u0131na al\u0131narak izlenir. Bu tedaviye cevap vermeyenlerde etkilenen akci\u011fer alan\u0131 cerrahi olarak \u00e7\u0131kar\u0131l\u0131r.<\/p>\n
PN\u00d6MOMED\u0130AST\u0130NUM<\/p>\n
S\u0131kl\u0131\u011f\u0131 t\u00fcm Canl\u0131 do\u011fumlarda 1000 de 2.5 olup solunum yetmezli\u011fi, aspirasyon sendromu, pn\u00f6moni olan hastalarla, solunum cihaz\u0131nda takip edilen bebeklerde g\u00f6r\u00fcl\u00fcr. Sadece pn\u00f6momediastinum olan vakalarda solunum s\u0131k\u0131nt\u0131s\u0131 genellikle hafiftir. Tedavi gerekmez. Solunum s\u0131k\u0131nt\u0131s\u0131 varsa oksijen verilir d\u00fczelmeyen hastalarda t\u00fcp tak\u0131larak izlenir.<\/p>\n
PN\u00d6MOPER\u0130KARD\u0130UM<\/p>\n
Genellikle tansiyon d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc, kalp at\u0131mlar\u0131nda yava\u015flama ve \u015foka kadar de\u011fi\u015febilen a\u011f\u0131r bulgulara neden olur. S\u0131kl\u0131kla solunum cihaz\u0131nda olan d\u00fc\u015f\u00fck do\u011fum a\u011f\u0131rl\u0131kl\u0131 erken do\u011fan bebeklerde g\u00f6r\u00fcl\u00fcr. G\u00f6\u011f\u00fcs r\u00f6ntgeninde kalbin etraf\u0131n\u0131 saran hava g\u00f6lgesi tan\u0131 koydurucudur. Nadiren bulgu vermeyecek kadar hafif olabilir. Tedavide g\u00f6\u011f\u00fcs t\u00fcp\u00fc tak\u0131l\u0131r. \u00d6l\u00fcm oran\u0131\u00a0 %80-90′ d\u0131r. Ya\u015fayanlarda n\u00f6rolojik bozukluklar g\u00f6r\u00fclebilir.<\/p>\n
PN\u00d6MOPER\u0130TONEUM<\/p>\n
Kar\u0131n bo\u015flu\u011fu i\u00e7ine g\u00f6\u011f\u00fcsten hava s\u0131zmas\u0131 nedeniyle geli\u015fir. E\u011fer b\u00fcy\u00fck ise tan\u0131 r\u00f6ntgen ile konur. G\u00f6\u011fse bask\u0131 yaparak solunum s\u0131k\u0131nt\u0131s\u0131na neden olmaz ise tedavi gerekmez. Solunum s\u0131k\u0131nt\u0131s\u0131 varsa i\u011fne ya da t\u00fcp tak\u0131larak hava bo\u015falt\u0131l\u0131r.<\/p>\n
HAZIRLAYAN;Dr. Emel ALTUNCU,Dr. Hayrettin YILDIZ,Dr. M. G\u00f6n\u00fcl AYDO\u011eAN<\/p>\n
KAYNAKLAR:Mac Donald MG,\u00a0 Mullett MD, Seshia MMK. Avery’s\u00a0 Neonatology\u00a0 Pathophysiology & management\u00a0 of\u00a0 the\u00a0 Newborn. 6 th ed. Lippincott Williams&Wilkins comp. O. Neyzi, T. Ertu\u011frul. Pediatri. T\u00fcrkanDa\u011fo\u011flu. Neonatoloji, 2000. Nobel T\u0131p Kitabevleri.<\/p>\n","protected":false},"excerpt":{"rendered":"
Akci\u011fer dokusu i\u00e7ine veya d\u0131\u015far\u0131 do\u011fru olan Hava s\u0131z\u0131nt\u0131lar\u0131 en s\u0131k, yenido\u011fan d\u00f6neminde g\u00f6r\u00fcl\u00fcr. Akci\u011feri \u00e7evreleyen zarlar\u0131n aras\u0131na hava ka\u00e7mas\u0131 (pn\u00f6motoraks), akci\u011ferdeki damar ve hava bo\u015fluklar\u0131n\u0131n aras\u0131na hava s\u0131zmas\u0131 (interstisyel amfizem), akci\u011fer ile g\u00f6\u011f\u00fcs bo\u015flu\u011fu aras\u0131na hava ka\u00e7mas\u0131 (pn\u00f6momediastinum) ve akci\u011fer ile kalp zar\u0131 aras\u0131na hava s\u0131zmas\u0131 (pn\u00f6moperikardium) \u015feklinde g\u00f6r\u00fclen formlar\u0131 vard\u0131r. Bu tablolar\u0131n hepsi yenido\u011fanlarda ani k\u00f6t\u00fcle\u015fmeye yol a\u00e7ar[Devam\u0131n\u0131 Oku…]<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[22524],"tags":[23282,23286,23285,23284],"_links":{"self":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts\/13276"}],"collection":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/comments?post=13276"}],"version-history":[{"count":0,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts\/13276\/revisions"}],"wp:attachment":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/media?parent=13276"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/categories?post=13276"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/tags?post=13276"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}