Off-Pump ile On-Pump Koroner Bypass Cerrahisinde İnflamatuar Yanıtın Karşılaştırılması
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Tarih
2012
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmamızda off-pump ve on-pump yöntemi ile koroner bypass operasyonu yapılan hastalardaki inflamatuar yanıtta önemli olan tümör nekrozis faktör-alfa (TNF-?) ile Creaktif protein (CRP) değerleri karşılaştırılarak klinik yansımaları incelenmiştir. Çalışma planı: Kliniğimizde koroner bypass operasyonu yapılan 40 hasta çalışmaya alındı. Birinci grup on- pump hastaları (Grup I, n20), ikinci grup ise off pump (Grup II, n20) hastalarından oluşturuldu. Her iki grupta operasyondan bir gün önce ve postoperatif 6.saatte tümör nekrozis faktör, ayrıca operasyondan bir gün önce, postoperatif 1. ve 3. günlerde C-reaktif protein ile akyuvar düzeylerine bakıldı. Sonuçlar: Karşılaştırdığımız tümör nekrozis faktör düzeylerinde preoperatif dönemde anlamlı bir fark izlenmezken (p0.098), postoperatif dönemdeki tümör nekrozis faktör düzeyleri Grup Ide anlamlı olarak daha yüksek bulundu (p0.016). Her iki gruptaki preoperatif C-reaktif protein düzeyleri arasında anlamlı bir fark bulunmazken (p0.074), Grup Ide postoperatif 1. ve 3. gündeki C-reaktif protein düzeyleri anlamlı olarak daha yüksek bulundu (p0.021 - p:0.019). Her iki grubun preoperatif (p0.094), postoperatif 1.gün (p0.091) ve postoperatif 3.gün (p0.095) white blood cell düzeyleri arasında istatistiksel olarak anlamlı bir fark saptanmadı. Tartışma: Kardiyo-pulmoner by-pass kullanılarak yapılan operasyonlarda inflamatuar yanıtın bir göstergesi olan tümör nekrozis faktör ve C-reaktif protein düzeyleri atan kalpte yapılanlara oranla anlamlı derecede yüksek bulunmuştur.
Objective: In this study, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) levels which are important in inflammatory response to off pump and on pump coronary by-pass surgery, were compared and their clinical reflections were examined. Study plan: Forty patients who underwent coronary artery by-pass grafting in our clinic, were included in the study. The first group included on-pump patients (Group I, n20) and second group included off pump patients (group II, n20). In both groups the day before surgery and post operative sixth hour of tumor necrosis factor, as well as the day before surgery, post operative first and third days of C - reactive protein levels were measured. Results: In the comparison of TNF- α levels, while the preoperative levels were not significantly different in both groups (p0.098), postoperative levels of Group 1 were significantly higher (p0.016). In both groups any significant difference between pre operative CRP levels (p0.074) was not found. In Group I, the first and third postoperative day CRP levels were significantly higher (p0.021-p0.019). White blood cell levels of each group at preoperative (p0.094), post operative 1st day (p0.091) and post operative 3rd day (p0.095) were not significantly different. Conclusion: As an indicator of inflammatory response, the tumor necrosis factor- α and Creactive protein levels were significantly higher in operations using cardiopulmonary by-pass than surgeries on beating heart
Objective: In this study, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) levels which are important in inflammatory response to off pump and on pump coronary by-pass surgery, were compared and their clinical reflections were examined. Study plan: Forty patients who underwent coronary artery by-pass grafting in our clinic, were included in the study. The first group included on-pump patients (Group I, n20) and second group included off pump patients (group II, n20). In both groups the day before surgery and post operative sixth hour of tumor necrosis factor, as well as the day before surgery, post operative first and third days of C - reactive protein levels were measured. Results: In the comparison of TNF- α levels, while the preoperative levels were not significantly different in both groups (p0.098), postoperative levels of Group 1 were significantly higher (p0.016). In both groups any significant difference between pre operative CRP levels (p0.074) was not found. In Group I, the first and third postoperative day CRP levels were significantly higher (p0.021-p0.019). White blood cell levels of each group at preoperative (p0.094), post operative 1st day (p0.091) and post operative 3rd day (p0.095) were not significantly different. Conclusion: As an indicator of inflammatory response, the tumor necrosis factor- α and Creactive protein levels were significantly higher in operations using cardiopulmonary by-pass than surgeries on beating heart
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14
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3
