{"id":8442,"date":"2025-01-22T13:55:49","date_gmt":"2025-01-22T11:55:49","guid":{"rendered":"https:\/\/thorax.gr\/el\/?p=8442"},"modified":"2025-01-22T13:55:49","modified_gmt":"2025-01-22T11:55:49","slug":"%ce%b1%ce%b9%ce%bc%ce%bf%ce%b8%cf%89%cf%81%ce%b1%ce%ba%ce%b1%cf%83-%cf%84%ce%b9-%cf%80%cf%81%ce%b5%cf%80%ce%b5%ce%b9-%ce%bd%ce%b1-%ce%b3%ce%bd%cf%89%cf%81%ce%b9%ce%b6%ce%b5%cf%84%ce%b5","status":"publish","type":"post","link":"https:\/\/thorax.gr\/tr\/%ce%b1%ce%b9%ce%bc%ce%bf%ce%b8%cf%89%cf%81%ce%b1%ce%ba%ce%b1%cf%83-%cf%84%ce%b9-%cf%80%cf%81%ce%b5%cf%80%ce%b5%ce%b9-%ce%bd%ce%b1-%ce%b3%ce%bd%cf%89%cf%81%ce%b9%ce%b6%ce%b5%cf%84%ce%b5\/","title":{"rendered":"HEMOTORAS: B\u0130LMEN\u0130Z GEREKENLER NELERD\u0130R?"},"content":{"rendered":"

Hemotoraks, travma, ameliyat veya di\u011fer patolojik durumlardan kaynaklanabilecek plevral bo\u015flukta (akci\u011fer ile g\u00f6\u011f\u00fcs duvar\u0131 aras\u0131ndaki bo\u015fluk) kan birikmesidir. Tedavi \u015fiddetine ve altta yatan nedene ba\u011fl\u0131d\u0131r. Bir dizi neden ve semptom, doktorlar\u0131n durumu h\u0131zl\u0131 bir \u015fekilde tan\u0131mas\u0131na ve tedavi etmesine yard\u0131mc\u0131 olabilir. <\/span>En yayg\u0131n neden, k\u0131r\u0131k bir kaburgadan kaynaklanan delinme yaras\u0131 veya bir araba kazas\u0131ndan kaynaklanan k\u00fcnt kuvvet travmas\u0131 gibi g\u00f6\u011f\u00fcste travmatik bir yaralanmad\u0131r. <\/span>\u0130nsanlar hemotoraks\u0131n ilerlemesine ba\u011fl\u0131 olarak farkl\u0131 semptomlar ya\u015fayabilir. <\/span> Hemotoraks\u0131n te\u015fhisi hem fizik muayeneyi hem de g\u00f6r\u00fcnt\u00fclemeyi i\u00e7erebilir. <\/span>Bu ciddi durumun tedavisi, yaralanm\u0131\u015fsa hastan\u0131n stabilize edilmesini, g\u00f6\u011f\u00fcsteki t\u00fcm kan\u0131n al\u0131nmas\u0131n\u0131 ve kanama kayna\u011f\u0131n\u0131n durdurulmas\u0131n\u0131 i\u00e7erir.<\/span><\/p>\n

Sebepler<\/span><\/h2>\n

Hemotoraks durumunda kan, g\u00f6\u011f\u00fcs duvar\u0131 ile akci\u011fer aras\u0131nda yer alan plevral bo\u015fluk ad\u0131 verilen bo\u015flukta toplan\u0131r. A\u015fa\u011f\u0131dakiler de dahil olmak \u00fczere \u00e7e\u015fitli olas\u0131 nedenler vard\u0131r:<\/span> Yaralanma:<\/strong> <\/span>Travmatik hemotoraks s\u0131kl\u0131kla g\u00f6\u011f\u00fcs veya akci\u011ferleri kaplayan plevral membran\u0131n y\u0131rt\u0131lmas\u0131na neden olur. Bu membran y\u0131rt\u0131lmas\u0131, kan\u0131 drenaj yolu olmayan plevral bo\u015flu\u011fa ak\u0131t\u0131r. <\/span>G\u00f6\u011f\u00fcs duvar\u0131 veya akci\u011ferlerdeki k\u00fc\u00e7\u00fck yaralanmalar bile hemotoraksa yol a\u00e7abilir. <\/span>Acil sa\u011fl\u0131k personelinin, bir kaza veya spor yaralanmas\u0131 gibi di\u011fer darbeli yaralanmalardan sonra ki\u015finin akci\u011ferlerini hemotoraks belirtileri a\u00e7\u0131s\u0131ndan incelemesi protokol haline geldi.<\/span><\/p>\n

Di\u011fer nedenler<\/span><\/h2>\n

Baz\u0131 ki\u015filer altta yatan ko\u015fullara ba\u011fl\u0131 olarak hemotoraks a\u00e7\u0131s\u0131ndan daha b\u00fcy\u00fck risk alt\u0131nda olabilir:<\/span><\/p>\n

    \n
  • t\u00fcberk\u00fcloz gibi akci\u011fer enfeksiyonlar\u0131;<\/span><\/li>\n
  • akci\u011fer veya plevra kanseri gibi baz\u0131 kanserler veya maligniteler<\/li>\n
  • akci\u011ferlerde kan p\u0131ht\u0131s\u0131 olan pulmoner emboli<\/li>\n
  • \u00f6rne\u011fin antikoag\u00fclan ila\u00e7lar\u0131n veya hemofili kullan\u0131m\u0131na ba\u011fl\u0131 olarak kan\u0131n p\u0131ht\u0131la\u015fmas\u0131ndaki kusurlar<\/li>\n
  • pulmoner enfarkt\u00fcs gibi akci\u011fer dokusu disfonksiyonu<\/li>\n<\/ul>\n

    \u00a0<\/p>\n

    Hemotoraks, ven\u00f6z kateter yerle\u015ftirilmesi veya kalp ameliyat\u0131 gibi t\u0131bbi bir prosed\u00fcrden de kaynaklanabilir.\u00a0<\/span>G\u00f6\u011f\u00fcs yaralanmas\u0131ndan kaynaklanabilecek di\u011fer bir sorun da pn\u00f6motorakst\u0131r. Bu durumda g\u00f6\u011f\u00fcs bo\u015flu\u011funda hava toplan\u0131r. Bir ki\u015fide her ikisine de sahipse buna hemopn\u00f6motoraks denir.<\/span><\/p>\n

    Belirtiler<\/span><\/h2>\n

    Hemotoraks, belirtiler a\u00e7\u0131k de\u011filse hem hastalar\u0131n hem de doktorlar\u0131n bunu tan\u0131mas\u0131na yard\u0131mc\u0131 olabilecek baz\u0131 benzersiz semptomlar sunar. Hemotoraks belirtileri \u015funlar\u0131 i\u00e7erir:<\/span><\/p>\n

      \n
    • g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131, \u00f6zellikle nefes al\u0131rken<\/span><\/li>\n
    • so\u011fuk, soluk veya nemli cilt<\/span><\/li>\n
    • h\u0131zl\u0131 kalp at\u0131\u015f h\u0131z\u0131<\/span><\/li>\n
    • d\u00fc\u015f\u00fck tansiyon<\/span><\/li>\n
    • gergin, h\u0131zl\u0131 veya y\u00fczeysel nefes alma;<\/span><\/li>\n
    • nefes almada zorluk<\/span><\/li>\n
    • huzursuzluk duygular\u0131<\/span><\/li>\n<\/ul>\n

      \u00a0<\/p>\n

      Te\u015fhis<\/span><\/h2>\n

      Fizik muayene s\u0131ras\u0131nda doktorlar, stetoskop arac\u0131l\u0131\u011f\u0131yla anormal solunum seslerini dinleyeceklerdir. Doktorlar, s\u0131v\u0131n\u0131n seslerini g\u00f6\u011fs\u00fcne perk\u00fcsyon (t\u0131bbi vuru\u015f) uygulayarak duyabilirler. <\/span>Di\u011fer te\u015fhis y\u00f6ntemleri \u015funlar\u0131 i\u00e7erir:<\/span><\/p>\n

      Radyografiler:<\/strong> G\u00f6\u011f\u00fcs bo\u015flu\u011funda s\u0131v\u0131 olup olmad\u0131\u011f\u0131n\u0131 g\u00f6\u011f\u00fcs r\u00f6ntgeni g\u00f6r\u00fcnt\u00fcs\u00fc h\u0131zla ortaya \u00e7\u0131karacakt\u0131r.<\/span><\/p>\n

      BT taramas\u0131<\/strong>: Doktorlara akci\u011ferlerin ve plevra bo\u015flu\u011funun tam bir resmini verebilir, bu \u00f6zellikle travma vakalar\u0131nda \u00f6nemli olabilir. Tam g\u00f6\u011f\u00fcs BT taramas\u0131 genellikle hemotoraks\u0131n nedenini ve ki\u015fi i\u00e7in en iyi tedaviyi ortaya \u00e7\u0131karabilir.<\/span><\/p>\n

      Ultrason:<\/strong> Acil durumlarda, ultrason g\u00f6r\u00fcnt\u00fcleri potansiyel hasar ve hemotoraks a\u00e7\u0131s\u0131ndan plevral bo\u015flu\u011fa h\u0131zl\u0131 ve do\u011fru bir bak\u0131\u015f sa\u011flar.<\/span><\/p>\n

      Tedavi<\/span><\/h2>\n
        \n
      1. Hastan\u0131n stabilizasyonu<\/strong>:\n
          \n
        • Hayati belirtilerin sa\u011flanmas\u0131 (kalp at\u0131\u015f h\u0131z\u0131, nefes alma, kan bas\u0131nc\u0131).<\/li>\n
        • Gerekirse oksijen verin.<\/li>\n
        • Hipovolemiyi s\u0131v\u0131 ve\/veya kan transf\u00fczyonu ile tedavi edin.<\/li>\n<\/ul>\n<\/li>\n
        • Plevral bo\u015fluktan kan\u0131n al\u0131nmas\u0131<\/strong>:\n
            \n
          • G\u00f6\u011f\u00fcs t\u00fcp\u00fcn\u00fcn tak\u0131lmas\u0131 (torakostomi): Kan\u0131 bo\u015faltmak i\u00e7in plevral bo\u015flu\u011fa bir t\u00fcp yerle\u015ftirilir.<\/li>\n
          • Torasentez: Daha k\u00fc\u00e7\u00fck hemotorakslarda basit aspirasyon yap\u0131labilir.<\/li>\n<\/ul>\n<\/li>\n
          • Kanama tedavisi<\/strong>:\n
              \n
            • Hemotoraks b\u00fcy\u00fckse veya kanama devam ediyorsa (ba\u015flang\u0131\u00e7ta >1500 ml veya >200 ml\/saat) cerrahi m\u00fcdahale gerekebilir.<\/li>\n
            • Torakoskopik cerrahi (VATS): Tan\u0131 ve tedaviye minimal invazif yakla\u015f\u0131m.<\/li>\n
            • Torakotomi: Kanaman\u0131n yerini tespit etmek ve durdurmak i\u00e7in yap\u0131lan a\u00e7\u0131k ameliyatt\u0131r.<\/li>\n<\/ul>\n<\/li>\n
            • Altta yatan nedenleri ele almak<\/strong>:\n
                \n
              • Travmatik hemotoraksta travma (kaburga k\u0131r\u0131\u011f\u0131, organ y\u0131rt\u0131lmas\u0131 gibi) tedavi edilir.<\/li>\n
              • Travmatik olmayan hemotoraksta kanser veya anevrizma y\u0131rt\u0131lmas\u0131 gibi durumlar ara\u015ft\u0131r\u0131l\u0131r.<\/li>\n<\/ul>\n<\/li>\n
              • \u0130zleme<\/strong>:\n
                  \n
                • \u0130yile\u015fmeyi de\u011ferlendirmek i\u00e7in g\u00f6\u011f\u00fcs r\u00f6ntgeni veya CT taramas\u0131 ile d\u00fczenli kontroller.<\/li>\n
                • Ampiyem (plevral s\u0131v\u0131 enfeksiyonu) veya pn\u00f6motoraks gibi komplikasyonlar\u0131 izleyin.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n

                  <\/h3>\n

                  Sons\u00f6z<\/h2>\n

                  Hemotoraks, tedavi edilmedi\u011fi takdirde ya\u015fam\u0131 tehdit edebilecek ciddi bir durumdur. Ki\u015fi t\u0131bbi yard\u0131m ald\u0131\u011f\u0131nda te\u015fhis ve tedavi sonu\u00e7lar\u0131 iyidir. \u0130yile\u015fme, ki\u015finin tedaviye ne kadar iyi yan\u0131t verdi\u011fine ve kan\u0131n plevral bo\u015fluktan temizlenmesinin ne kadar s\u00fcrd\u00fc\u011f\u00fcne ba\u011fl\u0131d\u0131r.<\/span><\/p>","protected":false},"excerpt":{"rendered":"

                  Hemotoraks, travma, ameliyat veya di\u011fer patolojik durumlardan kaynaklanabilecek plevral bo\u015flukta (akci\u011fer ile g\u00f6\u011f\u00fcs duvar\u0131 aras\u0131ndaki bo\u015fluk) kan birikmesidir. Tedavi \u015fiddetine ve altta yatan nedene ba\u011fl\u0131d\u0131r. Bir dizi neden ve semptom, doktorlar\u0131n durumu h\u0131zl\u0131 bir \u015fekilde tan\u0131mas\u0131na ve tedavi etmesine yard\u0131mc\u0131 olabilir. En yayg\u0131n neden, k\u0131r\u0131k bir kaburgadan kaynaklanan delinme yaras\u0131 veya bir araba kazas\u0131ndan kaynaklanan k\u00fcnt kuvvet travmas\u0131 gibi g\u00f6\u011f\u00fcste travmatik bir yaralanmad\u0131r. \u0130nsanlar hemotoraks\u0131n ilerlemesine ba\u011fl\u0131 olarak farkl\u0131 semptomlar ya\u015fayabilir. Te\u015fhis [\u2026]<\/p>","protected":false},"author":12,"featured_media":8441,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[400],"tags":[402,451,448,452,453,454,455,237,456,411,457],"class_list":["post-8442","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-400","tag-thoraxgr","tag-451","tag-448","tag-452","tag-453","tag-454","tag-455","tag-237","tag-456","tag-411","tag-457"],"_links":{"self":[{"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/posts\/8442","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/comments?post=8442"}],"version-history":[{"count":1,"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/posts\/8442\/revisions"}],"predecessor-version":[{"id":8443,"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/posts\/8442\/revisions\/8443"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/media\/8441"}],"wp:attachment":[{"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/media?parent=8442"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/categories?post=8442"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thorax.gr\/tr\/wp-json\/wp\/v2\/tags?post=8442"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}