ÇOCUKLUK ÇAÐI TOPLUMSAL KAYNAKLI PNÖMONÝLERÝNÝN DEÐERLENDÝRÝLMESÝ VE TEDAVÝ YAKLAÞIMLARI

Toplumsal kaynaklý pnömoni, hastaneye yatmadan veya yattýktan sonraki ilk 48 saat içinde meydana gelen pnömonilere verilen isimdir. Bu çalýþmada amacýmýz, Temmuz 1997-Aralýk 1999 tarihleri arasýnda kliniðimizde yatýrýlarak izlenen 247 toplumsal kaynaklý pnömoni olgusunu retrospektif olarak, tedavi cevaplarý, tedavi süreleri, yan etkiler ve risk faktörleri açýsýndan incelemekti. Hastalarýmýzýn 134 tanesi erkek, 113 tanesi kýz ve ortalama yaþlarý 5,6±2,8 yýl idi. Demir eksikliði ve malnütrüsyon en önemli risk faktörü idi. Baþvuru semptom ve bulgularý %92 ateþ, %70 öksürük, %42 nefes darlýðý, %28 yan aðrýsý, %21 karýn aðrýsý. %18 þuur deðiþikliði idi. Hastalarýmýzýn hiçbiri yoðun bakým tedavisi gerektirmedi. Radyografik incelemede %62 unilateral, %38 bilateral tutulum mevcuttu. Lökositoz 94 hastada (%37,7 ) saptanýrken, 45 hastada (%18) lökopeni saptanmýþtý. Baþlangýç tedavisi olarak 92 hastaya (%37,2) penisilin, 112 hastaya (%45.3) penisilin ve 3.kuþak sefalosporin baþlanmýþtý. Diðer hastalardan 18'i(%7,3) ampisilin-sulbaktam, 25'i(%10.3) ampisilin-sulbaktam ve 3. kuþak sefalosporin kombinasyonu kullanmýþtý. Ortalama radyolojik iyileþme süresi 12 gün idi. Mortalite yoktu.

EVALUATION AND TREATMENT OF COMMUNITY ACQUIRED PNEUMONIAE

Community acquired pneumonia is the name given to the pneumonia which occur either before going to the hospital or within the first 48 hours after coming to the hospital. In this study, our purpose is to present total 247 patients hospitalized in our clinic between 1997 July to 1999 December, of whom response of treatment, the mean treatment duration, side effects and risk factors have been evaluated. The study group included 113 girls, 134 boys and mean ages were 5.6 ( 2.8 years. Iron deficiency anemia and nialnutration were found out as the most important rise factors. The presenting clinical symptoms and signs were fever 92%, cough 70%, dyspnea 42%, chest pain 28%, abdominal pain 21%, deterioration of conciousness 18%. None of our patient needed to be treated in intensive care unit. Radiographic findings' distribution were 62% unilateral, 38% bilateral. Leucocytosis was found in 94 patients (37,7%) and leucocyt count was reduced in 45 patients (18%). The choose of initial treatment was penicilin in 92 patients (37.2%), penicilin combined with a third-generation cephalosporin in 112 patients (45.3%), ampicilline-sulbactam in 18 patients (7.3%) and ampicilline-sulbactam combined with a third generation cephalosporin in 25 patients (10.3%), The mean treatment duration was 10 days and radiographic clearence was seen in 12 days. Mortality was not found.