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PrIKaZ sLUČaja CasE rEPOrT Intrapleuralna streptokinaza kod dece sa parapneumoničnom efuzijom

Boris Kovacevic ,
Boris Kovacevic
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Vladimir Spica ,
Vladimir Spica
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Ljubica Spica
Ljubica Spica
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Published: 01.12.2010.

Biochemistry

Volume 27, Issue 2 (2011)

pp. 329-332;

https://doi.org/10.5937/matmed1102329k

Abstract

Parapneumonična efuzija kod dece definiše se obično kao nakupljanje pleuralne tečnosti u toku akutne bakterijske pneumonije, a ređe u sklopu virusne pneumonije i tuberkuloznog pleuritisa. Empijem označava prisustvo purulentnog sadržaja u pleuralnom prostoru. Pleuralna infekcija je kontinuum, ali klasično postoji podela u tri stadijuma: eksudativni, fibropurulentni i organizovani. Glavni bakterijski uzročnici su Pneumococcus, Streptococcus pyogenes i Staphylococcus aureus. Postoje dve kliničke prezentacije parapneumonične efuzije. Kada sumnjamo na pleuralni izliv, sprovodi se standardizovan terapijsko-dijagnostički postupak prema smernicama BTS vodiča. Ukoliko perzistira signifikantna količina pleuralne tečnosti i dođe do kompromitovanja plućne funkcije, tada govorimo o komplikovanoj parapneumoničnoj efuziji i indikovana je torakalna drenaža. Pri pojavi septacija i lokulacija u pleuralnom prostoru, neophodna je intrapleuralna instilacija fibrinolitika. Primena Streptokinaze je bezbedna, efikasna, smanjuje potrebu za hirurškim lečenjem i zajedno sa ostalim terapijskim merama dovodi do kompletnog oporavka deteta.

Keywords

pleuralna efuzija,

torakalna drenaža,

streptokinaza,

deca

References

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