DOKUZ YILLIK TRAVMA OLGULARIMIZ

Genç nüfus popülasyonunda önde gelen ölüm nedenlerinden olan travma, son dokuz yýllýk travmalý olgu kayýtlarýmýz retrospektif incelenerek gözden geçirildi. 1.7.1990-11.4.1999 tarihleri arasýnda travma nedeniyle kliniðimize yatýrýlan 212 olgudan 190'ý (%89.6) ameliyat edilip 22' sine (%10.4) seçici gözlem uygulandý. Olgulardan 36' sý kadýn (%17), 176'sý (%83) erkekti. Yaþ ortalamasý 32.4(16-81) olarak bulundu. Olgulardan 93' ü (%43.9) trafik kazasýna (TK), 56' sý (%26.4) kesid-delici alet yaralanmasýna (KDAY), 33' ü (%15.6) ateþli silah yaralanmasýna (ASY), 30' u (% 14.1) künt travmaya maruz kalmýþtý. Taný, TK (%95.1) ve künt travmada (%76.9) çoðunlukla diagnostik peritoneal lavaj (DPI), ASY da fizik muayene (%59.4), KDAY da ise fizik muayene ve lokal yara eksplorasyonu (%77.5) ile konuldu. TK ve künt travma olgularýnda en fazla yaralanan organ dalak (%51.4), penetran travmalarda ise ince barsaklardý (%35.8). Negatif laparotomi oranýmýz literatürden fazla olup 47 olgu (%24.7) negatif eksplorasyon olarak deðerlendirildi. Negatif laparotomi ile en fazla KDAY h olgularda (%49) karþýlaþýldý. Ancak seçici gözlem uygulanan 22 olgunun 17' si (%77.3) son iki yýl içindeydi ve son iki yýl içinde 6 olgu negatif laparotomi olarak deðerlendirildi. Son iki yýlda ki olgularýmýz göz önüne alýndýðýnda negatif laparotomi oranýmýz % 14 bulundu ve önceki yýllara göre düþüþ gösterdiði görüldü. Mortalite ve morbidite oranýmýz kabul edilebilir düzeydedir.

OUR TRAUMA CASES OF THE LAST NINE YEARS

Trauma is one of the major cause of death in the young population. The patients treated due to trauma were evaluated retrospectively during the last nine years. 212 cases with trauma were hospitalised in our clinic, between 1.7.1990-11.4.1999. 190 189.6%) of them were operated and 22 (10.4%) of them were observed selectively. 36 (17%) of the cases were female and 176 (83%) of them were male. The mean age was 32.4 (16-81). 93 (43%) of them were hospitalized following traffic accidents; 56 (26.4%) of them stab wounds, 33 (15.6%) of them gunshots and 30 (14.1%) of them blunt trauma. The diagnose was done through the diagnostic peritoneal lavage 95.1% of the traffic accident cases. The diagnose was performed through diagnostic peritoneal lavage 76.9% of the after blunt trauma cases. After gunshots the diagnose was done by 59.4% of the cases with physical examination. Local lesion exploration helped us to establish the diagnose 51.4% of the stab wound cases. The most frequent organ injury following traffic accidents is splenic injury and injury of small intestine following penetrating trauma. The amount of our negative laparotomy was more than in literature and 47 (24.7%) cases were accepted as negative exploration. Negative laparotomy was seen mostly by stabwounds (49%). 17 (77.3%) of the 22 cases observed selectively were the cases of the last two years. In the recent two years the amount our negative laparotomy was six and our negative laparotomy ratio is 14%. Our mortality and the morbidity rates were at the acceptable level.