SPLENEKTOMÝ SONRASI ERKEN DÖNEM ÝNFEKSÝYONLAR

Splenektominin erken postoperatif devrede infeksiyon riskini artýrýp artýrmadýðýný araþtýrmak amacýyla, splenektomi geçiren 39 hasta prospektif olarak incelendi. Yaþlarý 2ay-64 yýl arasýnda deðiþen hastalar, infekte (15 hasta) ve noninfekte (24 hasta) alarak iki gruba ayrýldý. Ýnfekte grupta toplam 21 infeksiyon ataðý gözlendi: 11 solunum yolu infeksiyonu, 3 üriner sistem infeksiyonu, 3 bakteriyemi, 2 intraabdominal abse ve 2 yara yeri infeksiyonu. Alýnan kültürlerden 8'inde (%26.6) Pnömokoklar koagülaz pozitif, 4'ünde (%13.3)beta hemolitik stretokok, 4'ünde (%13.3) E.Koli ve 2'sinde (%6.6) Kandida tek baþlarýna veya kombine halde üredi. Postoperatif devrede 10 gün boyunca beyaz küre sayýmý ve ateþ takibi yapýldý. Ýnfekte grupta ortalama beyaz küre sayýsý 15821.14/mm3 ve ortalama ateþ deðerleri 37.35 idi. Noninfekte grupta ise bu deðerler sýrasýyla 10509.00/mm3 ve 36.75 C idi. 1 hastada postoperatif devrede çok aðýr sepsis geliþti. Yaptýðýmýz çalýþma sonucunda, dalaðýn çýkarýlmasýndan sonra septik komplikasyon riskinin küçümsenemeyecek derecede olduðu ve özellikle beyaz küre (BK) sayýmýnýn postoperatif dönemde fizyolojik olmayýp bir infeksiyon göstergesi olduðu sonucuna vardýk.

POSTSPLENECTOMY EARLY PERIOD INFECTIONS

39 patients who underwent splenectomy were investigated to determine whether early postoperative injection risk increases after splenectomy. Patients, ranging in age from 2 months to 64 years, were divided into two groups. 1) infected (n=15) and 2) noninfected (n=24). There were 21 episodes of infection: 11 respiratory tract infections, 3 urinary tract infections, 3 bacteremias, 2 intraabdominal abscesses and 2 wound infections. Pneumococcus were cultured from 8 (26.6%) of the septic foci, Enterobacter aerogenes were cultured from (20%), Staphylococcus coagulase positive were cultured from 6 (20%)beta hemolytic streptoccus were cultured from (13.3%), E. Coli were cultured from 4 (13.3%) and Candida were cultured from 2 (6.6%) of the septic foci. Group average alternate daily WBC (white blood cell) counts and daily maximum body temperature of 37.35 C. In the noninfected group, these values were 10509.00/mm3 and 36.75 C, respectively. Only one patient developed overwhelming postspnenectomy sepsis. We concluded that the frequency of septic complications after removal of the spleen is considerable, and WBC count predicts infection in the postoperative period not physiologic.