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D\u00fcnyada \u00f6l\u00fcm nedenleri aras\u0131nda d\u00f6rd\u00fcnc\u00fc s\u0131rada yer alan KOAH (Kronik T\u0131kay\u0131c\u0131 Akci\u011fer Hastal\u0131\u011f\u0131) hastalar\u0131, Covid-19\u2019u daha a\u011f\u0131r ge\u00e7irme riskine sahip.<\/p>\n
T\u00fcrk Toraks Derne\u011fi 23. sanal kongresine kat\u0131lan KOAH \u00c7al\u0131\u015fma Grubu Sekreteri Do\u00e7. Dr. Aylin Alpayd\u0131n, KOAH\u2019\u0131n akci\u011ferdeki hava yollar\u0131n\u0131n mikrobik olmayan iltihaplanmas\u0131 ile ortaya \u00e7\u0131kan; bron\u015f ve\/veya hava keseciklerinin harabiyetine neden olan yayg\u0131n, \u00f6nlenebilir ve tedavi edilebilir bir akci\u011fer hastal\u0131\u011f\u0131 oldu\u011funu s\u00f6yledi.<\/p>\n
KOAH\u2019\u0131n t\u00fcm d\u00fcnyada \u00f6nemli bir halk sa\u011fl\u0131\u011f\u0131 sorunu olmas\u0131na kar\u015f\u0131n, yeterince bilinmedi\u011finin alt\u0131n\u0131 \u00e7izen Alpayd\u0131n, “KOAH\u2019\u0131n g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131 d\u00fcnyada 40 ya\u015f \u00fcst\u00fc yeti\u015fkinlerde y\u00fczde 8.4-15.0, T\u00fcrkiye\u2019de ise y\u00fczde 5.3-19.1 aras\u0131ndad\u0131r. Yani T\u00fcrkiye\u2019de 40 ya\u015f \u00fczerinde her 5 ki\u015fiden birinde KOAH oldu\u011fu tahmin edilmektedir. KOAH, d\u00fcnyada \u00f6l\u00fcm nedenleri aras\u0131nda d\u00f6rd\u00fcnc\u00fc s\u0131rada yer almaktad\u0131r. N\u00fcfusun ya\u015flanmas\u0131 ve KOAH risk fakt\u00f6rlerine maruziyetin artarak s\u00fcrmesi nedeniyle hastal\u0131k y\u00fck\u00fc ve hastal\u0131k nedeniyle \u00f6l\u00fcm giderek artmaktad\u0131r. T\u00fcrkiye\u2019de solunum sistemi hastal\u0131klar\u0131 \u00f6l\u00fcm nedenleri aras\u0131nda \u00fc\u00e7\u00fcnc\u00fc s\u0131kl\u0131ktad\u0131r ve bu \u00f6l\u00fcmlerin y\u00fczde 60 kadar\u0131 KOAH nedeniyle ortaya \u00e7\u0131kmaktad\u0131r” dedi.<\/p>\n
Alpayd\u0131n, “KOAH geli\u015fimi i\u00e7in t\u00fcm d\u00fcnyada en yayg\u0131n g\u00f6r\u00fclen risk fakt\u00f6r\u00fc t\u00fct\u00fcn \u00fcr\u00fcnlerine (sigara, nargile, puro, \u0131s\u0131t\u0131lm\u0131\u015f t\u00fct\u00fcn \u00fcr\u00fcnleri) maruziyettir. \u00c7evresel t\u00fct\u00fcn duman\u0131 da KOAH geli\u015fimine katk\u0131da bulunmaktad\u0131r. KOAH geli\u015fiminde etkili oldu\u011fu g\u00f6sterilen di\u011fer risk fakt\u00f6rleri, genetik (s\u0131n\u0131rl\u0131 \u00f6l\u00e7\u00fcde), akci\u011fer geli\u015fiminde yetersizlik ile ili\u015fkili hasta fakt\u00f6rleri (d\u00fc\u015f\u00fck do\u011fum a\u011f\u0131rl\u0131\u011f\u0131, \u00e7ocuklukta s\u0131k ge\u00e7irilen solunum yolu infeksiyonlar\u0131), sa\u011fl\u0131kta e\u015fitsizlik, biyomas (odun, tezek, benzeri yak\u0131t) kullan\u0131m\u0131na ikincil i\u00e7 ortam hava kirlili\u011fi, tozlu, dumanl\u0131 i\u015fyerlerinde \u00e7al\u0131\u015fma, son y\u0131llarda \u00f6nemi giderek vurgulanmaya ba\u015flayan fiziksel aktivitede azalma. KOAH\u2019da en s\u0131k g\u00f6r\u00fclen yak\u0131nmalar nefes darl\u0131\u011f\u0131, \u00f6ks\u00fcr\u00fck ve balgam \u00e7\u0131karmad\u0131r. Sigara i\u00e7en ki\u015filer \u00f6ks\u00fcr\u00fck ve balgam\u0131 kan\u0131ksarlar ve bu nedenle doktora ba\u015fvurmazlar. KOAH\u2019\u0131n tan\u0131s\u0131, basit ve a\u011fr\u0131s\u0131z bir test olan \u2019nefes \u00f6l\u00e7\u00fcm testi\u2019 ile kolayca konabilmektedir” dedi.<\/p>\n
KOAH\u2019\u0131n tedavisi<\/p>\n
KOAH\u2019\u0131n \u00f6nlenebilir ve tedavi edilebilir bir hastal\u0131k oldu\u011funu belirten Alpayd\u0131n, “KOAH tan\u0131s\u0131 konulan ki\u015filerin bu hastal\u0131\u011fa neden olan ve hastal\u0131\u011f\u0131n k\u00f6t\u00fcle\u015fmesine ve ilerlemesine yol a\u00e7an sigara kullan\u0131m\u0131n\u0131 b\u0131rakmalar\u0131, zararl\u0131 toz, gaz duman\u0131ndan, hava kirlili\u011finden uzak durmalar\u0131 gereklidir. KOAH tedavisinde nefes a\u00e7\u0131c\u0131 \u00f6zellikte \u201cinhaler\u201d olarak adland\u0131r\u0131lan solunum yolu ile uygulanan ila\u00e7lar ile hava yollar\u0131ndaki daralman\u0131n ve mikrobik olmayan iltihaplanman\u0131n \u00f6n\u00fcne ge\u00e7ilmesi ama\u00e7lanmaktad\u0131r. Bu sayede nefes darl\u0131\u011f\u0131n\u0131n ve alevlenme riskinin azalt\u0131lmas\u0131 hedeflenmektedir. Solunum yetmezli\u011fi olan KOAH\u2019l\u0131 hastalarda evde oksijen tedavisi ve\/veya evde solunum cihaz\u0131 tedavisi gibi tedavilere ihtiya\u00e7 olabilmektedir. Hastal\u0131\u011f\u0131n k\u00f6t\u00fcle\u015fmesi ve seyrini etkileyen, hatta \u00f6l\u00fcmlere neden olan ataklardan ve zat\u00fcrreden korunmak i\u00e7in grip ve zat\u00fcrre a\u015f\u0131lar\u0131n\u0131n yapt\u0131r\u0131lmas\u0131 ve nefes yoluyla al\u0131nan ila\u00e7 tedavilerinin d\u00fczg\u00fcn uygulanmas\u0131 gerekir. Bu tedavilerin yan\u0131 s\u0131ra fiziksel aktivitenin ve gerekirse akci\u011fer rehabilitasyonu uygulanmas\u0131 hastalar\u0131n g\u00fcnl\u00fck ya\u015famlar\u0131n\u0131n daha kaliteli hale gelmesini sa\u011flar. Son y\u0131llarda KOAH hastal\u0131\u011f\u0131n\u0131n \u00f6zg\u00fcn bir alt grubunda, t\u00fcm t\u0131bbi tedavilere ra\u011fmen yak\u0131nmalar\u0131n fazla oldu\u011fu hastalarda, ayr\u0131nt\u0131l\u0131 incelemeler yap\u0131ld\u0131ktan sonra bronkoskopi ile yap\u0131lan sarmal tel veya valf yerle\u015ftirme veya termal uygulama tedavileri, akci\u011ferlerde ortaya \u00e7\u0131kan a\u015f\u0131r\u0131 derecede havalanman\u0131n (hacim art\u0131\u015f\u0131n\u0131n) azalt\u0131lmas\u0131 i\u00e7in \u00f6nerilen giri\u015fimsel i\u015flemlerdir. Ancak, daha \u00f6nce de belirtildi\u011fi gibi bu tedaviler her KOAH hastas\u0131 i\u00e7in uygun de\u011fildir. Tedavinin gereklili\u011fi de\u011ferlendirilmeli ve yarar g\u00f6recek hastalar\u0131n belirlenmesi i\u00e7in ayr\u0131nt\u0131l\u0131 incelemeler yap\u0131lmal\u0131d\u0131r. Bu tedavilerdeki en \u00f6nemli husus hastal\u0131\u011f\u0131 de\u011fil etkilerini ge\u00e7ici bir s\u00fcre giderebilecek tedaviler olmalar\u0131d\u0131r, yani hastal\u0131\u011f\u0131n ortadan kald\u0131rmazlar. Son zamanlarda \u2018KOAH\u2019da bronkoskopik balon tedavisi\u2019 hakk\u0131nda haberlere bas\u0131n yay\u0131n kurulu\u015flar\u0131nda s\u0131k yer verildi\u011fi g\u00f6r\u00fclmektedir. KOAH hastal\u0131\u011f\u0131n\u0131n uluslararas\u0131 kabul g\u00f6ren tan\u0131 ve tedavi rehberlerinde yer almayan, yay\u0131nla\u015fm\u0131\u015f iki \u00e7al\u0131\u015fmayla etkili oldu\u011fu ifade edilen balon tedavisinin kamuoyuna hastal\u0131\u011f\u0131n tedavisi bulundu \u015feklinde yans\u0131t\u0131lmas\u0131, hastalar\u0131n yanl\u0131\u015f y\u00f6nlendirilmesine ve hasta ma\u011fduriyetlerine sebep olmaktad\u0131r. Bu nedenle, KOAH tedavisinde etkinli\u011fi ve g\u00fcvenilirli\u011fi bir\u00e7ok \u00e7al\u0131\u015fmayla g\u00f6sterilmi\u015f bilimsel kan\u0131tlar \u0131\u015f\u0131\u011f\u0131nda, uluslararas\u0131 rehberlerde kabul edilen ve \u00f6nerilen tedavi yakla\u015f\u0131mlar\u0131n\u0131n hastalar\u0131m\u0131za uygulanmas\u0131n\u0131n hayati \u00f6nemde oldu\u011funu belirtmek isteriz. T\u00fcm bu bilgilerden anla\u015f\u0131laca\u011f\u0131 \u00fczere KOAH\u2019l\u0131 hastalar\u0131n tedavilerinin gere\u011fince planlamas\u0131nda, bilgi ve kan\u0131ta dayal\u0131 olarak ayr\u0131nt\u0131l\u0131 bir de\u011ferlendirme gerekmektedir. Bunun i\u00e7in yeterince zaman \u015fart olup, yine bu y\u0131l kongrede sunulacak bir \u00e7al\u0131\u015fmada KOAH\u2019l\u0131 hasta de\u011ferlendirmesinde en \u00f6nemli sorunlardan birinin yetersiz hasta bak\u0131m s\u00fcresi olmas\u0131 \u00e7arp\u0131c\u0131d\u0131r” dedi.<\/p>\n
KOAH hastalar\u0131nda Covid -19\u2019un daha s\u0131k g\u00f6r\u00fclmemekle beraber, KOAH hastalar\u0131n\u0131n Covid -19\u2019u daha a\u011f\u0131r ge\u00e7irme riskine sahip olduklar\u0131n\u0131 kaydeden Alpayd\u0131n, “KOAH hastalar\u0131 da toplumun t\u00fcm bireyleri gibi Covid-19\u2019a kar\u015f\u0131 standart \u00f6nlemeler almal\u0131d\u0131r.<\/p>\n
KOAH atak ile ili\u015fkili yak\u0131nmalar\u0131 COVID-19 enfeksiyonunda da g\u00f6r\u00fclebilir. Bu nedenle, risk fakt\u00f6rleri varl\u0131\u011f\u0131nda ay\u0131r\u0131c\u0131 tan\u0131 mutlaka yap\u0131lmal\u0131d\u0131r. Kortizon tedavisinin alevlenmelerde kullan\u0131m\u0131 Covid-19 varl\u0131\u011f\u0131nda bile \u00f6nerilmektedir. KOAH hastalar\u0131nda temel hedef hastal\u0131\u011f\u0131 mevcut idame tedavisinde de\u011fi\u015fiklik yapmadan (pandemi \u00f6ncesinde kullan\u0131lan KOAH ila\u00e7lar\u0131na yan\u0131 \u015fekilde devam ederek) stabil halde tutabilmektir. Oksijen ve ev noninvaziv ventilat\u00f6r tedavilerine yine yan\u0131 \u015fekilde devam edilmelidir. Yap\u0131lan \u00e7al\u0131\u015fmalarda, pandemi nedeniyle y\u00fcz y\u00fcze klinik ziyaretlerin azald\u0131\u011f\u0131 tespit edilmi\u015f, ayn\u0131 \u015fekilde pulmoner rehabilitasyon programlar\u0131 kesintiye u\u011frad\u0131\u011f\u0131 g\u00f6zlenmi\u015ftir. KOAH hastalar\u0131 alevlenme d\u00f6nemlerini evde ge\u00e7irmeyi tercih etmi\u015flerdir. Bu s\u00fcre\u00e7ler i\u00e7in telesa\u011fl\u0131k \u201dUzaktan ya da Online\u201d sa\u011fl\u0131k uygulamalar\u0131 geli\u015ftirilmeye \u00e7al\u0131\u015f\u0131lmaktad\u0131r. KOAH \u00f6nemli bir toplum sa\u011fl\u0131\u011f\u0131 problemidir. T\u00fcm kronik hastal\u0131klarda oldu\u011fu gibi KOAH hastalar\u0131 da pandemi s\u00fcrecinden etkilenmi\u015ftir. Ancak, KOAH hastalar\u0131n\u0131n bak\u0131m\u0131 t\u00fcm d\u00fcnyada uzaktan s\u00fcre\u00e7lerle desteklenerek devam ettirilmektedir” diye konu\u015ftu.<\/p>\n","protected":false},"excerpt":{"rendered":"
D\u00dcNYADA \u00d6L\u00dcM NEDENLER\u0130 ARASINDA D\u00d6RD\u00dcNC\u00dc SIRADA YER ALAN KOAH (KRON\u0130K TIKAYICI AKC\u0130\u011eER HASTALI\u011eI) HASTALARI, COV\u0130D-19\u2019U DAHA A\u011eIR GE\u00c7\u0130RME R\u0130SK\u0130NE SAH\u0130P.<\/p>\n","protected":false},"author":1,"featured_media":1541067,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14,20],"tags":[14189,117035,13777,39110,15966,12772,42970,12746],"class_list":["post-1541066","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-saglik","category-turkiye","tag-agir","tag-covid-19u","tag-daha","tag-gecirme","tag-hastalari","tag-koah","tag-riskine","tag-sahip"],"_links":{"self":[{"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/posts\/1541066","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=1541066"}],"version-history":[{"count":0,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/posts\/1541066\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/media\/1541067"}],"wp:attachment":[{"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1541066"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1541066"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1541066"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}