Öz
Amaç: Post-dural ponksiyon baş ağrısı (PDPH) dural defekten
dolayı meydana gelen serobrospinal sıvı kaybı ile ilişkili major bir komplikasyondur.
Trombositler doku iyileşmesi ve homeostasis’te önemli rol oynarlar. Ortalama
trombosit hacmi (MPV) trombosit fonksiyonunun bir göstergesidir. Bu çalışmada
PDPH ve MPV arasındaki ilişkiyi araştırmak istedik.
Yöntem: Ocak 2016 ile Ocak 2018 arasında, spinal anestezi ile
sezaryen geçiren 182 hasta bu çalışmaya dahil edildi. Hastalar PDPH (+) ve PDPH
(-) olmak üzere iki gruba ayrıldı. PDPH'ye göre hastaların preoperatif ve
postoperatif hemoglobin (HGB), hematokrit (HCT), trombosit (PLT), MPV, beyaz
kan hücresi (WBC), nötrofil (NEUT) ve lenfosit (LYMPH) düzeyleri
değerlendirildi.
Bulgular: PDPH (+)
hastalarının preoperatif ve postoperatif MPV değerleri arasında fark yoktu (sırasıyla
10.77±1.17, 10.83±1.04, p =0.483) ama PDPH (-) hastalarının MPV değerleri
arasında anlamlı fark vardı (sırasıyla 10.94±1.20, 11.10±1.11, p <0.001).
Sonuç: PDPH'nin oluşumunu etkileyen ve tahmin eden birçok sebep vardır. Bu çalışmaya
göre, postoperatif MPV düzeyleri (yüksek veya düşük) PDPH için bir öngörüye
neden olabilir.
Anahtar Kelimeler
Post-dural ponksiyon baş ağrısı Ortalama trombosit hacmi Nötrofil
Kaynakça
- Referans1.Evans RW. Complications of lumbar puncture. Neurologic Clinics 1998;16:83-105.Referans2.Grant R, Condon B, Hart I, Teasdale GM. Changes in intracranial CSF volume after lumbar puncture and their relationship to post-LP headache. J Neurol Neurosurg Psychiatry. 1991;54:440-2.Referans3.Carson D, Serpell M. Choosing the best needle for diagnostic lumbar puncture. Neurology 1996;47:33-7.Referans4.Dodge HS, Ekhator NN, Jefferson-Wilson L, et al. Cigarette smokers have reduced risk for post-dural puncture headache. Pain Physician 2013;16:25-30.Referans5.Stadelmann WK, Digenis AG, Tobin GR. Physiology and healing dynamics of chronic cutaneous wounds. Am J Surg 1998;176:26-38.Referans6.Demirin H, Ozhan H, Ucgun T, et al. Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study. Thromb Res 2011;128:358-60.Referans7.Grageda, E. Platelet-Rich Plasma and bone graft materials: A review and a standardized research protocol. İmplant Dentistry 2004;13:301-9.Referans8.Boos CJ, Lip GY. Platelet activation and cardiovascular outcomes in acute coronary syndromes. J Thromb Haemost 2006;4:2542-3.Referans9.Qin B, Ma N, Tang Q, et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 2016;26:372-6.Referans10.Liu S, Carpenter RL, Neal JM. Epidural anesthesia and analgesia. Anesthesiology 1995;82:1474-506.Referans11.Ben, J, Crul P, Gerritse BM, et al. Epidural Fibrin Glue Injection Stops Persistent Post Dural Puncture Headache. Anesthesiology 1999;91:576-7.Referans12.Saxena S, Jain P, Shukla J. Preparation of Two Component Fibrin Glue and Its Clinical Evaluation in Skin Grafts and Flaps. Indian Journal of Plastic Surgery 2003;36:14-17.Referans13.Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth 2003;91:718-29.Referans14.Eppley BL,Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: Implications for wound healing. Plast Reconstr Surg 2004;114:1502-8.Referans15.Sanchez AR, Sheridan PJ, Kupp LI. Is plateletrich plasma the perfect enhancement factor? A current review. The International J. Oral & Maxillofacial Implants 2003;18:93103.Referans16.De La Mata, J. Platelet rich plasma. A new treatment tool for the rheumatologist?. Reumatol Clin 2013;9:166-71.Referans17.Ahmed, M, Reffat SA, Hassan A, Eskander F. Platelet-Rich Plasma for the Treatment of Clean Diabetic Foot Ulcers. Ann. Vasc. Surg 2017;38:206-11.Referans18.Amorim JA,Valença MM. Postdural puncture headache is a risk factor for new postdural puncture headache. Cephalalgia 2008;28:5-8.Referans19.Amorim JA, Gomes de Barros MV, Valença MM. Post-dural (post-lumbar) puncture headache: risk factors and clinical features. Cephalalgia 2012;32:916-23.Referans20.Ghatge S, Uppugonduri S, Kamarzaman Z. Cerebral venous sinus thrombosis following accidental dural puncture and epidural blood patch. Int J Obstet Anesth 2008;17:267-70.Referans21.Anderson M. The properties of aminophylline. Emerg Nurse 2007;15:24-7.Referans22.Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996;7:157-61.Referans23.Ranjith MP, Divya R, Mehta VK, et al. Significance of platelet volume indices and platelet count in ischaemic heart disease. J Clin Pathol 2009;62:830-3.Referans24.Kupper TE, Strohl KP, Hoefer M, et al. Low-dose theophylline reduces symptoms of acute mountain sickness. Journal of Travel Medicine 2008;15:307-14.Referans25.Smith JB, Araki H, Lefer AM. Thromboxane A2, prostacyclin and aspirin: effects on vascular tone and platelet aggregation. Circulation1980;62:19-25.Referans26.Park JE, Barbul A. Understanding the role of immune regulation in wound healing. Am J. Surg 2004;187:11-6.Referans27.Greenhalgh DG. The role of apoptosis in wound healing. Int J Biochem Cell Biol. 1998;30:1019-30.Referans28.Cantürk NZ, Esen N, Vural B et al. The relationship between neutrophils and incisional wound healing. Skin Pharmacol Appl Skin Physiol 2001;14:108-16.Referans29.Maruyama Y, Inoue K, Mori K, et al. Neutrophil-lymphocyte ratio and platelet lymphocyte ratio as predictors of wound healing failure in head and neck reconstruction. Acta Otolaryngol 2017;137:106-10.
Öz
Objective: Post-dural puncture headache (PDPH) is a major complication associated
with loss of cerebrospinal fluid (CSF), which occurs due to dural defect. Platelets
play an important role in tissue healing and homeostasis. Mean platelet volume
(MPV) is an indication of platelet function. In this study we wanted to
investigate the relationship between MPV and PDPH.
Method: Between
January 2016 and January 2018, 182 patients who had a caesarean using spinal
anaesthesia were included in this study. Patients were divided into two groups
as PDPH (+) and PDPH (-). The preoperative and postoperative haemoglobin (HGB),
haematocrit (HCT), platelet (PLT), MPV, white blood cell (WBC), neutrophil
(NEUT) and lymphocyte (LYMPH) levels of the patients according to PDPH were
evaluated.
Results: There was
no difference between preoperative and postoperative MPV values of PDPH (+)
patients (respectively 10.77±1.17, 10.83±1.04, p=0.483) but there was a
significant difference between MPV values of PDPH (-) patients (respectively
10.94±1.20, 11.10±1.11, p<0.001).
Conclusions: There are a number of reasons that affect and predict
the occurrence of PDPH. According to this study, postoperative MPV levels (high
or low) could cause a prediction for PDPH.
Anahtar Kelimeler
Post-dural puncture headache Mean platelet volume Neutrophil
Kaynakça
- Referans1.Evans RW. Complications of lumbar puncture. Neurologic Clinics 1998;16:83-105.Referans2.Grant R, Condon B, Hart I, Teasdale GM. Changes in intracranial CSF volume after lumbar puncture and their relationship to post-LP headache. J Neurol Neurosurg Psychiatry. 1991;54:440-2.Referans3.Carson D, Serpell M. Choosing the best needle for diagnostic lumbar puncture. Neurology 1996;47:33-7.Referans4.Dodge HS, Ekhator NN, Jefferson-Wilson L, et al. Cigarette smokers have reduced risk for post-dural puncture headache. Pain Physician 2013;16:25-30.Referans5.Stadelmann WK, Digenis AG, Tobin GR. Physiology and healing dynamics of chronic cutaneous wounds. Am J Surg 1998;176:26-38.Referans6.Demirin H, Ozhan H, Ucgun T, et al. Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study. Thromb Res 2011;128:358-60.Referans7.Grageda, E. Platelet-Rich Plasma and bone graft materials: A review and a standardized research protocol. İmplant Dentistry 2004;13:301-9.Referans8.Boos CJ, Lip GY. Platelet activation and cardiovascular outcomes in acute coronary syndromes. J Thromb Haemost 2006;4:2542-3.Referans9.Qin B, Ma N, Tang Q, et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 2016;26:372-6.Referans10.Liu S, Carpenter RL, Neal JM. Epidural anesthesia and analgesia. Anesthesiology 1995;82:1474-506.Referans11.Ben, J, Crul P, Gerritse BM, et al. Epidural Fibrin Glue Injection Stops Persistent Post Dural Puncture Headache. Anesthesiology 1999;91:576-7.Referans12.Saxena S, Jain P, Shukla J. Preparation of Two Component Fibrin Glue and Its Clinical Evaluation in Skin Grafts and Flaps. Indian Journal of Plastic Surgery 2003;36:14-17.Referans13.Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth 2003;91:718-29.Referans14.Eppley BL,Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: Implications for wound healing. Plast Reconstr Surg 2004;114:1502-8.Referans15.Sanchez AR, Sheridan PJ, Kupp LI. Is plateletrich plasma the perfect enhancement factor? A current review. The International J. Oral & Maxillofacial Implants 2003;18:93103.Referans16.De La Mata, J. Platelet rich plasma. A new treatment tool for the rheumatologist?. Reumatol Clin 2013;9:166-71.Referans17.Ahmed, M, Reffat SA, Hassan A, Eskander F. Platelet-Rich Plasma for the Treatment of Clean Diabetic Foot Ulcers. Ann. Vasc. Surg 2017;38:206-11.Referans18.Amorim JA,Valença MM. Postdural puncture headache is a risk factor for new postdural puncture headache. Cephalalgia 2008;28:5-8.Referans19.Amorim JA, Gomes de Barros MV, Valença MM. Post-dural (post-lumbar) puncture headache: risk factors and clinical features. Cephalalgia 2012;32:916-23.Referans20.Ghatge S, Uppugonduri S, Kamarzaman Z. Cerebral venous sinus thrombosis following accidental dural puncture and epidural blood patch. Int J Obstet Anesth 2008;17:267-70.Referans21.Anderson M. The properties of aminophylline. Emerg Nurse 2007;15:24-7.Referans22.Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996;7:157-61.Referans23.Ranjith MP, Divya R, Mehta VK, et al. Significance of platelet volume indices and platelet count in ischaemic heart disease. J Clin Pathol 2009;62:830-3.Referans24.Kupper TE, Strohl KP, Hoefer M, et al. Low-dose theophylline reduces symptoms of acute mountain sickness. Journal of Travel Medicine 2008;15:307-14.Referans25.Smith JB, Araki H, Lefer AM. Thromboxane A2, prostacyclin and aspirin: effects on vascular tone and platelet aggregation. Circulation1980;62:19-25.Referans26.Park JE, Barbul A. Understanding the role of immune regulation in wound healing. Am J. Surg 2004;187:11-6.Referans27.Greenhalgh DG. The role of apoptosis in wound healing. Int J Biochem Cell Biol. 1998;30:1019-30.Referans28.Cantürk NZ, Esen N, Vural B et al. The relationship between neutrophils and incisional wound healing. Skin Pharmacol Appl Skin Physiol 2001;14:108-16.Referans29.Maruyama Y, Inoue K, Mori K, et al. Neutrophil-lymphocyte ratio and platelet lymphocyte ratio as predictors of wound healing failure in head and neck reconstruction. Acta Otolaryngol 2017;137:106-10.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Cerrahi Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Mart 2019 |
| Kabul Tarihi | 27 Mart 2019 |
| Yayımlandığı Sayı | Yıl 2019Cilt: 41 Sayı: 1 |