Akci\u011ferin solunum fonksiyonunu ilerleyici olarak k\u0131s\u0131tlayan; kal\u0131tsal ve sonradan edinilen bir grup hastal\u0131\u011f\u0131n kesin tedavisi, akci\u011fer naklini gerektirir. Bunlar aras\u0131nda k\u0131sa ad\u0131 son y\u0131llarda kamuoyunda s\u0131k\u00e7a rastlanan KOAH listenin ba\u015f\u0131ndad\u0131r. Hastal\u0131k her zaman kronik sigara al\u0131\u015fkanl\u0131\u011f\u0131 sonras\u0131 edinilir ve akci\u011fer nakillerin %40’\u0131n\u0131n nedenidir. Di\u011ferleri, daha ender g\u00f6r\u00fclen baz\u0131 meslek hastal\u0131klar\u0131 ve genetik hastal\u0131klard\u0131r.<\/p>\n
Ortak \u00f6zellik, akci\u011ferin basit anlamda kan\u0131 temizleme g\u00f6revini y\u00fcr\u00fcten k\u0131sm\u0131nda hastal\u0131k y\u00fcz\u00fcnden geri d\u00f6nd\u00fcr\u00fclemeyecek d\u00fczeyde hasar olu\u015fmas\u0131 veya etraf\u0131n\u0131n hastal\u0131kla sar\u0131l\u0131p g\u00f6revini yerine getirmesinin engellenmesidir. Bu nedenle akci\u011fer i\u015flevini yitirir ve temizlenemeyen kan di\u011fer organlara zarar vermeye ve hastay\u0131 yata\u011fa mahk\u00fbm etmeye ba\u015flar. Hastal\u0131\u011f\u0131n son d\u00f6nemlerinde akci\u011fer;\u00a0 g\u00f6\u011f\u00fcs kafesi i\u00e7inde fonksiyon g\u00f6rmeyen bir k\u00fctleye d\u00f6n\u00fc\u015f\u00fcr. Bu evrede hastaya, \u00e7ok yo\u011fun ila\u00e7 tedavileri ile bile ya\u015fam \u015fans\u0131 vermek \u00e7ok zordur.<\/p>\n
En ciddi yak\u0131nma, tahmin edilece\u011fi \u00fczere nefes darl\u0131\u011f\u0131d\u0131r. Bu hastal\u0131klar\u0131n ileri evrelerinde akci\u011ferleri, hastaya g\u00fcnl\u00fck ihtiya\u00e7lar\u0131n\u0131 (Tuvalet, banyo) bile tek ba\u015f\u0131na kar\u015f\u0131lamaya izin vermez. Di\u011fer yak\u0131nmalar, hastal\u0131\u011fa g\u00f6re de\u011fi\u015febilece\u011fi gibi; a\u015f\u0131r\u0131 kilo kayb\u0131, kan t\u00fck\u00fcrme, s\u0131k akci\u011fer enfeksiyonu ge\u00e7irme s\u0131k rastlan\u0131lan yak\u0131nmalard\u0131r. \u00dclkemizde akci\u011fer nakli olas\u0131l\u0131\u011f\u0131ndan haberdar olamayan veya bildi\u011fi halde herhangi bir nedenle bu \u015fans\u0131 de\u011ferlendiremeyecek olan hasta say\u0131s\u0131, rahatl\u0131kla binlerle ifade edilebilir. \u00c7ok yaz\u0131k ki bu hastalar, yo\u011fun bak\u0131mlarda g\u00fcnler, haftalar s\u00fcren sanc\u0131l\u0131 bir s\u00fcre\u00e7 sonras\u0131 veya kendi ve yak\u0131nlar\u0131n\u0131n istekleri ile yataklar\u0131nda ac\u0131 i\u00e7inde ya\u015famlar\u0131n\u0131n sonlanmas\u0131n\u0131 beklemektedir.<\/p>\n
Baz\u0131 hastal\u0131klara \u00f6zel s\u0131n\u0131rl\u0131 say\u0131da se\u00e7enek d\u0131\u015f\u0131nda tedavinin genel prensibi, akci\u011ferdeki geri d\u00f6n\u00fc\u015f\u00fcms\u00fcz y\u0131k\u0131m s\u00fcrecini olabildi\u011fince durdurmak veya yava\u015flatmak \u00fczerinedir. S\u00fcre\u00e7 i\u00e7inde, beslenme durumu, psikososyal yeterlili\u011fi, sigara ve Alkolden uzak duruyor olmas\u0131n\u0131 sa\u011flamak, hasta se\u00e7im kriterleri aras\u0131ndad\u0131r ve tedavinin de \u00f6nemli bir par\u00e7as\u0131n\u0131 olu\u015fturur. \u00d6nce, olas\u0131 al\u0131c\u0131n\u0131n se\u00e7ilme \u00f6l\u00e7\u00fctlerine uygunlu\u011fu ara\u015ft\u0131r\u0131l\u0131r ve sonu\u00e7 olumlu ise organ nakil bekleme listesine al\u0131n\u0131r. \u0130kinci ad\u0131m, verici bulundu\u011funda vericiye \u00f6zel \u00f6l\u00e7\u00fctlerle uygunluk aranmas\u0131d\u0131r. Bununla ilgili de yeterli say\u0131da kriter standardize edilmi\u015ftir. Basit\u00e7e s\u00f6ylenirse; 60 ya\u015f alt\u0131nda olmak, akci\u011fer hastal\u0131\u011f\u0131 \u00f6yk\u00fcs\u00fcn\u00fcn bulunmamas\u0131, sigara kullan\u0131m\u0131n\u0131n 20 paket.y\u0131l\u0131n alt\u0131nda olmas\u0131, kan yoluyla bula\u015fan hepatit ve HIV vir\u00fcs\u00fc ta\u015f\u0131y\u0131c\u0131l\u0131\u011f\u0131 ve enfeksiyonun olmad\u0131\u011f\u0131n\u0131n kan testleri ile do\u011frulanmas\u0131, g\u00f6\u011f\u00fcs \u00f6l\u00e7\u00fclerinin al\u0131c\u0131 ile uyumlu olmas\u0131 ve akci\u011fere \u00f6zel baz\u0131 testler kullan\u0131larak t\u00fcm\u00f6r, enfeksiyon gibi bir hastal\u0131k olas\u0131l\u0131\u011f\u0131n\u0131n ortadan kald\u0131r\u0131lmas\u0131 vericide uyulmas\u0131 gereken kriterlerdir. Uygun al\u0131c\u0131 ve verici haz\u0131r oldu\u011funda cerrahi ekibin bir k\u0131sm\u0131 vericiden organ\u0131 almaya giderken, bir k\u0131sm\u0131 da zaman kaybetmemek i\u00e7in al\u0131c\u0131y\u0131 operasyona al\u0131r ve gelecek organ i\u00e7in haz\u0131rl\u0131\u011f\u0131 yapar. \u0130lk ekip, baz\u0131 ila\u00e7 ve s\u0131v\u0131larla Canl\u0131 tutmaya \u00e7al\u0131\u015farak, akci\u011feri \u00e7\u0131kar\u0131r ve h\u0131zl\u0131 bir \u015fekilde operasyon odas\u0131na ula\u015ft\u0131r\u0131r. Ba\u015far\u0131l\u0131 bir operasyondan sonra ise s\u00fcrecin en kritik k\u0131sm\u0131 ba\u015flar. Bu, Ameliyat sonras\u0131 bak\u0131md\u0131r ve yo\u011fun bak\u0131m \u00fcnitesinde ger\u00e7ekle\u015fir. Ayn\u0131 zamanda en ciddi sorunlar\u0131n ba\u015flad\u0131\u011f\u0131 d\u00f6nemdir. Bu s\u00fcre\u00e7te, farkl\u0131 dal uzman\u0131 hekimler aras\u0131ndaki e\u015fg\u00fcd\u00fcm \u00f6nemlidir. <\/p>\n
Nakil s\u00fcreci, ba\u015f\u0131ndan sonuna kadar multidisipliner bir yakla\u015f\u0131m gerektiriyor. Nakil ekibi, g\u00f6\u011f\u00fcs cerrahisi, g\u00f6\u011f\u00fcs hastal\u0131klar\u0131, anesteziyoloji, enfeksiyon hastal\u0131klar\u0131, kardiyoloji, psikiyatri klinikleri ve yine \u00e7ok say\u0131da yard\u0131mc\u0131 Sa\u011fl\u0131k personelinden olu\u015fuyor. E\u015fg\u00fcd\u00fcm\u00fc zorla\u015ft\u0131ran bu durum, organ nakil koordinat\u00f6rleriyle \u00f6nemli \u00f6l\u00e7\u00fcde d\u00fczenlenebiliyor ise de, tam bir e\u015fg\u00fcd\u00fcm i\u00e7in t\u00fcm ekibin ayn\u0131 kararl\u0131l\u0131kla s\u00fcreci takip etmesi gerekir.<\/p>\n
Bir ba\u015fka sorun, nakil \u00f6ncesi ve sonras\u0131 kullan\u0131lan baz\u0131 ila\u00e7 ve organ koruyucu S\u0131v\u0131lar\u0131n y\u00fcksek maliyetidir. Bu masraf\u0131n sosyal g\u00fcvenlik kurumu taraf\u0131ndan kar\u015f\u0131lanabilmesi i\u00e7in gerekli yasal d\u00fczenlemelerin yap\u0131lmas\u0131 ile sorun a\u015f\u0131lacakt\u0131r.<\/p>\n
HAZIRLAYAN; Do\u00e7. Dr. Cemal As\u0131m KUTLU<\/p>\n","protected":false},"excerpt":{"rendered":"
Akci\u011ferin solunum fonksiyonunu ilerleyici olarak k\u0131s\u0131tlayan; kal\u0131tsal ve sonradan edinilen bir grup hastal\u0131\u011f\u0131n kesin tedavisi, akci\u011fer naklini gerektirir. Bunlar aras\u0131nda k\u0131sa ad\u0131 son y\u0131llarda kamuoyunda s\u0131k\u00e7a rastlanan KOAH listenin ba\u015f\u0131ndad\u0131r. Hastal\u0131k her zaman kronik sigara al\u0131\u015fkanl\u0131\u011f\u0131 sonras\u0131 edinilir ve akci\u011fer nakillerin %40’\u0131n\u0131n nedenidir. Di\u011ferleri, daha ender g\u00f6r\u00fclen baz\u0131 meslek hastal\u0131klar\u0131 ve genetik hastal\u0131klard\u0131r. Ortak \u00f6zellik, akci\u011ferin basit anlamda kan\u0131 temizleme[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":[23288,23287],"_links":{"self":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts\/13277"}],"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=13277"}],"version-history":[{"count":0,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts\/13277\/revisions"}],"wp:attachment":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/media?parent=13277"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/categories?post=13277"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/tags?post=13277"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}