Diyafragma rüptürlerinde intraperitoneal uygulanan metilen mavisi ve/veya urografin'in erken teşhisteki yeri (Deneysel çalışma)
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Dosyalar
Tarih
2008
Yazarlar
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Diyafragma rüptürlerinde intraperitoneal uygulanan metilen mavisi ve/veya urografin®in erken teşhisteki yeri (Deneysel Çalışma)Amaç: Diyafragma yaralanmasında çoğu kez hayatı tehdit edici ciddi yaralanmaların eşlik etmesi ve tüm dikkatin buna odaklanması yanı sıra erken dönemde herniasyonun spesifik muayene ve görüntüleme bulgularının olmaması yüzünden diyafragma rüptürünün erken tanısı güçtür. 1/3'ü geç dönemde tanı alabilmektedir. Bu çalışmada diyafragma rüptürü düşünülen hastalarda intraperitoneal olarak metilen mavisi ve/veya urografin® vererek metilen mavisinin toraks tüpünden drenajı, urografin®in ise direk akciğer grafisine yansımasını değerlendirerek bu zorluğun aşılabileceğini göstermeyi amaçladık.Gereç ve yöntem: Çalışmada 24 adet dişi Yeni Zelenda tavşanı kullanıldı. Biri kontrol grubu olmak üzere toplam dört grup oluşturuldu. Her grup 6 tavşandan oluştu. Bütün tavşanlara sol torakotomi yapıldı. Kontrol grubuna frenetomi işlemi yapılmadı, toraks dreni yerleştirip kesi yeri kapatıldı. Çalışma gruplarında ise 2. gruba anterior, 3. gruba sentrum, 4. gruba posterior lokalizasyonlu üçer cm'lik frenetomi insizyonu yapıldı, akabinde toraks direni yerleştirip torakotomi hattı kapatıldı. Daha sonra tavşan, supin-trandelenburg pozisyonuna getirildi. Batın bölgesinden intraperitoneal olarak metilen mavisi (7 mg/kg) verilerek toraks direninden gelip gelmediği 1 saat gözlendi. Daha sonra aynı kateterden meglumin amidotrizoat (Urografin® 7 mg/kg) verildi. 0, 15 ve 60. dakikalarda akciğer grafisi alındı. En anlamlı pozitiflik veren diyafragma rüptür lokalizasyonu (anterior, centrum ve posterior) ve intraperitoneal metilen mavisi ve/veya urografin® uygulamanın etkinliği belirlendi.Sonuçlar: Posterior frenetomi yapılan grupta (4.grup) metilen mavisi geçişi 4/6 ( % 66.7 ) ve urografin® geçişi 5/6 ( % 83.3 ) idi. Metilen mavisi ve urografin® geçişi bu grupta diğer gruplara göre daha anlamlı bulundu (p<0.05). İki maddenin geçiş süreleri arasında bir fark görülmedi (p>0.05). Ayrıca istatistiksel olarak birbirlerine karşı rüptürden geçiş üstünlüğü saptanmadı (p>0.05).Sonuç: Posterior diyafragmatik rüptürlerde intraperitoneal olarak uygulanan metilen mavisi ve/veya urografin® tanısaldır.
The value of the methylene blue and/or urografin through intraperitoneal in early diagnosis of diaphragmatic ruptures (Experimental Study)Background: In diaphragma injuries besides accompanying serious injuries which threaten life and focusing all attention to this, it's difficult to diagnose diaphragma ruptures earlier because of the absence of specific examination and filming diagnosis of herniation in early period of time. One out of three is diagnosed in a late period of time. We aimed to show see that we can deal this the difficulty by evaluating drainage of methylene blue from thorax tube and urografin's directly reflection to lungs diagram by giving methylene blue and urografin as intraperitoneal to the patients who have diaphragma ruptures.Materials and methods: In the study twenty-four female New Zealand rabbits were used. In total four groups are constitued, one of them is the control group. Each group consists of six rabbits. To all rabbits, left thoracotomy were applied. Any phrenotomy operation wasn't applied to the control group, just a thorax tube was put and rupture place was covered. In study groups, anterior to the second group, sentrum to the third group, posterior to the fourth group with localization three centimered phrenotomy incision was made, after that thorax tube was set and thoracotomy line was closed. Then the rabbit was brought into the supine-trendelenburg position. As intraperitoneal methylene blue (7 mg/kg) was given from abdomen part and then it was observed for an hour that if it comes or not from thorax tube. After that meglumine amidotrizoate (Urografin® 7 mg/kg) was givenfrom the same catheter. And the lung diagram was X-rayed on each the zero, the fifteenth and the sixtieth minutes. The diaphragma rupture localization which gives the most meaningful positiveness and the activity of intraperitoneal application were determined.Results: On the group applied to posterior phrenotomy, methylene blue transition was four out of six ( % 66.7 ) and urografin transition was five out of six ( % 83.3 ). The methylene blue and the urografin transition was found more meaningful in this group than the other groups (p<0.05). Any difference was seen between the transition times of contrast substances (p>0.05). Also as statistical any transition superiority against each other from ruptures wasn't determined (p>0.05).Conclusion: On posterior diaphragmatic ruptures methylene blue and urografin applied as intraperitoneal were diagnostic.
The value of the methylene blue and/or urografin through intraperitoneal in early diagnosis of diaphragmatic ruptures (Experimental Study)Background: In diaphragma injuries besides accompanying serious injuries which threaten life and focusing all attention to this, it's difficult to diagnose diaphragma ruptures earlier because of the absence of specific examination and filming diagnosis of herniation in early period of time. One out of three is diagnosed in a late period of time. We aimed to show see that we can deal this the difficulty by evaluating drainage of methylene blue from thorax tube and urografin's directly reflection to lungs diagram by giving methylene blue and urografin as intraperitoneal to the patients who have diaphragma ruptures.Materials and methods: In the study twenty-four female New Zealand rabbits were used. In total four groups are constitued, one of them is the control group. Each group consists of six rabbits. To all rabbits, left thoracotomy were applied. Any phrenotomy operation wasn't applied to the control group, just a thorax tube was put and rupture place was covered. In study groups, anterior to the second group, sentrum to the third group, posterior to the fourth group with localization three centimered phrenotomy incision was made, after that thorax tube was set and thoracotomy line was closed. Then the rabbit was brought into the supine-trendelenburg position. As intraperitoneal methylene blue (7 mg/kg) was given from abdomen part and then it was observed for an hour that if it comes or not from thorax tube. After that meglumine amidotrizoate (Urografin® 7 mg/kg) was givenfrom the same catheter. And the lung diagram was X-rayed on each the zero, the fifteenth and the sixtieth minutes. The diaphragma rupture localization which gives the most meaningful positiveness and the activity of intraperitoneal application were determined.Results: On the group applied to posterior phrenotomy, methylene blue transition was four out of six ( % 66.7 ) and urografin transition was five out of six ( % 83.3 ). The methylene blue and the urografin transition was found more meaningful in this group than the other groups (p<0.05). Any difference was seen between the transition times of contrast substances (p>0.05). Also as statistical any transition superiority against each other from ruptures wasn't determined (p>0.05).Conclusion: On posterior diaphragmatic ruptures methylene blue and urografin applied as intraperitoneal were diagnostic.
Açıklama
Anahtar Kelimeler
Metilen mavisi, urografin, diyafragma rüptürü, Methylene blue, Urografin, Diaphragma rupture
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Tartar, H. (2008). Diyafragma rüptürlerinde intraperitoneal uygulanan metilen mavisi ve/veya urografin'in erken teşhisteki yeri (Deneysel çalışma). (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Göğüs Cerrahisi Anabilim Dalı, Konya.
