![](\"http:\/\/www.erzurumflas.com\/wp-content\/uploads\/2015\/11\/turk-hekim-dunya-tip-literaturune-girdi_c96096d.jpg\")
Do\u00e7. Dr. Fuat B\u00fcy\u00fckbayrak, MDS (Myeloblastik Displastik Sendrom) hastas\u0131na yapt\u0131\u011f\u0131 a\u00e7\u0131k kalp ameliyat\u0131yla d\u00fcnya t\u0131p literat\u00fcr\u00fcne girdi.<\/p>\nDo\u00e7. Dr. Fuat B\u00fcy\u00fckbayrak, MDS (Myeloblastik Displastik Sendrom) hastas\u0131na yapt\u0131\u011f\u0131 a\u00e7\u0131k kalp ameliyat\u0131yla d\u00fcnya t\u0131p literat\u00fcr\u00fcne girdi.<\/p>\n
Ayakkab\u0131 sanayinden emekli ve bu ya\u015f\u0131na kadar hi\u00e7bir sa\u011fl\u0131k problemi ya\u015famam\u0131\u015f 60 ya\u015f\u0131ndaki Ahmet Ayd\u0131n, ge\u00e7ti\u011fimiz sene gittik\u00e7e artan yorgunluk ve g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 \u015fikayetiyle hastaneye gitti. Kalp rahats\u0131zl\u0131\u011f\u0131 ile ba\u015flayan, MDS (Myeloblastik Displastik Sendrom) tan\u0131s\u0131yla devam eden ve hastanede yap\u0131lan a\u00e7\u0131k kalp ameliyat\u0131yla sa\u011fl\u0131\u011f\u0131na kavu\u015fan Ahmet Ayd\u0131n; MDS hastal\u0131\u011f\u0131 olup kalp ameliyat\u0131 yap\u0131lan yedinci hasta olarak d\u00fcnya t\u0131p literat\u00fcr\u00fcne girdi.<\/p>\n
Ge\u00e7ti\u011fimiz y\u0131l yorgunluk ve g\u00f6\u011fs\u00fcnde a\u011fr\u0131 \u015fikayetleriyle hastaneye ba\u015fvurdu\u011funu s\u00f6yleyen Ahmet Ayd\u0131n, \u201c\u015eikayetlerim giderek art\u0131yordu. Kardiyoloji b\u00f6l\u00fcm\u00fcne gittim. Anjiyo yap\u0131lmas\u0131na karar verildi ve kan de\u011ferlerime bak\u0131ld\u0131. \u00c7ok d\u00fc\u015f\u00fck oldu\u011fu ve bu de\u011ferlerle anjiyo yap\u0131lamayaca\u011f\u0131 i\u00e7in dahiliye b\u00f6l\u00fcm\u00fcnde tedavi olmam\u0131 istediler. Bir ayl\u0131k tedaviye ra\u011fmen kan de\u011ferlerim y\u00fckselmedi ve \u015fikayetlerim devam etti. Bilinmeyen bir kan kayb\u0131 olabilece\u011fi \u015f\u00fcphesiyle gastroenteroloji b\u00f6l\u00fcm\u00fcne y\u00f6nlendirdiler. Endoskopi ve kolonoskopi yap\u0131ld\u0131. Bunlar\u0131n sonucu da temizdi. Bu sefer hematolojiye g\u00f6nderdiler. Orada kemik ili\u011fimden biyopsi yap\u0131ld\u0131. Patoloji sonucuna g\u00f6re MDS\u2019ye ba\u011fl\u0131 Refrakter Anemi tan\u0131s\u0131 konuldu. Kemik ili\u011fim yeterli kan h\u00fccresi \u00fcretmiyordu. Bu s\u00fcre\u00e7te kalp problemlerim de artarak devam ediyordu. Gitti\u011fim b\u00fct\u00fcn kardiyoloji uzmanlar\u0131 anjiyo yap\u0131lmas\u0131 gerekti\u011fini s\u00f6yl\u00fcyorlard\u0131; ancak kanama kontrol\u00fc zor ve enfeksiyon riski \u00e7ok y\u00fcksek oldu\u011fu i\u00e7in anjiyo yapmaktan ka\u00e7\u0131n\u0131yorlard\u0131. Hisar Intercontinental Hospital Kardiyoloji B\u00f6l\u00fcm\u00fc\u2019ne geldik. Do\u00e7. Dr. Y\u0131lmaz G\u00fcne\u015f anjiyomu yapt\u0131; 3 damar\u0131m t\u0131kal\u0131yd\u0131. Kalp ve Damar Cerrahisi Uzman\u0131 Do\u00e7. Dr. Fuat B\u00fcy\u00fckbayrak\u2019la konu\u015ftuk ve kendisi hastal\u0131\u011f\u0131ma ra\u011fmen bu operasyonu yapabilece\u011fini s\u00f6yledi. Sonras\u0131nda ameliyat plan\u0131m yap\u0131ld\u0131. Hematolo\u011fumun kontrol\u00fcnde gerekli kan transferi yap\u0131larak ertesi g\u00fcn ameliyata al\u0131nd\u0131m. 1 g\u00fcn yo\u011fun bak\u0131mda kald\u0131m. Doktorlar\u0131m\u0131z cesaret etti ve \u00e7ok \u015f\u00fck\u00fcr bu ameliyat\u0131 sa\u011fl\u0131kla atlatt\u0131k\u201d dedi.<\/p>\n
MDS hastas\u0131na yapt\u0131\u011f\u0131 operasyonla d\u00fcnya t\u0131p literat\u00fcr\u00fcne yedinci vakay\u0131 ger\u00e7ekle\u015ftiren Hisar Intercontinental Hospital Kalp ve Damar Cerrahisi B\u00f6l\u00fcm Ba\u015fkan\u0131 Do\u00e7. Dr. Fuat B\u00fcy\u00fckbayrak; “Hastam\u0131z \u00f6nce g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 \u015fikayeti nedeniyle hastaneye gitmi\u015f; anjiyosunu yapmaktan kan de\u011ferlerinin d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc nedeniyle ka\u00e7\u0131n\u0131lm\u0131\u015f. Bu t\u00fcr vakalardan ka\u00e7\u0131n\u0131lmas\u0131n\u0131n temel nedeni enfeksiyon riskidir. Kanama problemini \u00e7\u00f6zebilirsiniz; ancak bu hastalarda ba\u011f\u0131\u015f\u0131kl\u0131k sistemi \u00e7ok zay\u0131f oldu\u011fu i\u00e7in en ufak bir enfeksiyon riski ciddi sonu\u00e7lar do\u011furabilir. MDS hastalar\u0131n\u0131n yo\u011fun bak\u0131m s\u00fcrecinin tek ki\u015filik yo\u011fun bak\u0131m odalar\u0131nda ve \u00e7ok \u00f6zel takip edilmesi gerekir. Hastam\u0131z bize ba\u015fvurdu\u011funda anjiyosu yap\u0131ld\u0131. 3 damar\u0131nda ciddi darl\u0131klar oldu\u011funu g\u00f6rd\u00fck ve by-pass yap\u0131lmas\u0131 gerekti\u011fini kendisiyle de payla\u015ft\u0131k. MDS hastalar\u0131nda daha \u00f6nce 4 tane koroner by-pass 2 tane de kapak ameliyat\u0131 yap\u0131lm\u0131\u015f. Bizimki be\u015finci koroner by-pass hastas\u0131 oldu. T\u00fcrkiye\u2019de yap\u0131lm\u0131\u015f ve literat\u00fcre girmi\u015f b\u00f6yle bir vaka yok. Bu nedenle T\u00fcrkiye\u2019deki ilk vakay\u0131 bizim yapt\u0131\u011f\u0131m\u0131z\u0131 s\u00f6yleyebiliriz. Ancak hastam\u0131z\u0131n MDS hastal\u0131\u011f\u0131 nedeniyle 100 bin civar\u0131nda olmas\u0131 gereken trombosit say\u0131s\u0131 18 bin; 7 bin civar\u0131nda olmas\u0131 gereken l\u00f6kosit say\u0131s\u0131 ise 2 bin civar\u0131ndayd\u0131. Hastam\u0131z\u0131 ameliyata haz\u0131rlamak i\u00e7in hematoloji uzman\u0131yla ileti\u015fime ge\u00e7erek tedavi \u015femas\u0131n\u0131 d\u00fczenledik. Trombosit y\u0131k\u0131m\u0131 s\u00f6z konusu oldu\u011fu i\u00e7in hastam\u0131za gerekli trombosit ve l\u00f6kosit de\u011ferlerini i\u00e7eren kan transferinin yap\u0131lmas\u0131n\u0131n hemen ard\u0131ndan ameliyata ald\u0131k. Hastam\u0131z\u0131n 3 damar\u0131na by-pass yapt\u0131k. Ameliyat s\u00fcrecinde ihtiyac\u0131 olan taze kan, trombosit gibi hayati destekleri haz\u0131r bulundurduk. Gayet ba\u015far\u0131l\u0131 ge\u00e7en bir operasyon ve 1 g\u00fcnl\u00fck yo\u011fun bak\u0131m s\u00fcrecinin ard\u0131ndan hastam\u0131z\u0131 servis kat\u0131m\u0131za ald\u0131k. Herhangi bir enfeksiyon problemi ya\u015famad\u0131k. Hastam\u0131z\u0131n \u00e7\u0131k\u0131\u015ftan sonraki tedavi s\u00fcrecini de hematolo\u011fuyla birlikte belirledik; birka\u00e7 g\u00fcn i\u00e7erisinde kontrollerini de tamamlayarak taburcu etmeyi d\u00fc\u015f\u00fcn\u00fcyoruz\u2019 ifadelerini kulland\u0131.<\/p>\n
MDS NED\u0130R?<\/p>\n
MDS, kemik ili\u011finin yeterince sa\u011fl\u0131kl\u0131 kan h\u00fccresi \u00fcretmemesine neden olan kemik ili\u011fi hastal\u0131\u011f\u0131d\u0131r.65 ya\u015f \u00fczerinde g\u00f6r\u00fclen hastal\u0131k; gen\u00e7leri de etkileyebilir. Kemik ili\u011finin fonksiyonu, k\u0131rm\u0131z\u0131 kan h\u00fccresi, beyaz kan h\u00fccresi ve plateletler olarak adland\u0131r\u0131lan \u00fc\u00e7 t\u00fcr kan h\u00fccresinin kayna\u011f\u0131 olan h\u00fccreleri \u00fcretmektir, bu olgunla\u015fmam\u0131\u015f h\u00fccreler normalde k\u0131rm\u0131z\u0131 kan h\u00fccresi, beyaz kan h\u00fccresi ve platelet olan fonksiyonel mat\u00fcr (olgun) h\u00fccrelere d\u00f6n\u00fc\u015f\u00fcr. MDS\u2019de olgun olmayan k\u00f6k h\u00fccreler kemik ili\u011finde birikir ve bu h\u00fccrelerin \u00f6mr\u00fc k\u0131salm\u0131\u015f olabilir, bu da dola\u015f\u0131mdaki olgun kan h\u00fccrelerinin azalmas\u0131yla sonu\u00e7lan\u0131r. Kan h\u00fccreleri say\u0131s\u0131ndaki azalma sitopeni olarak adland\u0131r\u0131l\u0131r ve enfeksiyon, anemi, kanama ve kolay \u00e7\u00fcr\u00fckler gibi MDS hastalar\u0131n\u0131n ya\u015fad\u0131\u011f\u0131 belirtilerin sorumlusudur. MDS\u2019de dola\u015f\u0131mdaki kan h\u00fccrelerinin say\u0131s\u0131n\u0131n azalmas\u0131n\u0131n yan\u0131 s\u0131ra dola\u015f\u0131mdaki kan h\u00fccreleri h\u00fccrelerin g\u00f6r\u00fcn\u00fcm ve morfolojisindeki normal d\u0131\u015f\u0131 \u015fekillenme nedeniyle uygun fonksiyon g\u00f6steremeyebilir.<\/p>\n","protected":false},"excerpt":{"rendered":"
DO\u00c7. DR. FUAT B\u00dcY\u00dcKBAYRAK, MDS (MYELOBLAST\u0130K D\u0130SPLAST\u0130K SENDROM) HASTASINA YAPTI\u011eI A\u00c7IK KALP AMEL\u0130YATIYLA D\u00dcNYA TIP L\u0130TERAT\u00dcR\u00dcNE G\u0130RD\u0130.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14,20],"tags":[23908,13746,16208,24533,14074,1039],"class_list":["post-133881","post","type-post","status-publish","format-standard","hentry","category-saglik","category-turkiye","tag-dunya","tag-girdi","tag-hekim","tag-literaturune","tag-tip","tag-turk"],"_links":{"self":[{"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/posts\/133881","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=133881"}],"version-history":[{"count":0,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/posts\/133881\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=133881"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=133881"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=133881"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}