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Prostate cancer profile in Dr. Sardjito General Yogyakarta 在日惹的Sardjito将军的前列腺癌概况
Pub Date : 2021-07-01 DOI: 10.19106/jmedsci005303202104
Yurisal Akhmad Dany, A. Z. Hendri, I. Soerohardjo
Prostate  cancer  is  the  fourth  most  common  type  of  non-skin  malignancy  in  male malignancies. In Indonesia, the definitive data are unreported, however, Globocan  reported  prostate  cancer  in  5th  place  in  2018.    Early  diagnosis  and  treatment  of  this  cancer  are  associated  with  reduced  mortality  rates.  This  study aimed to investigate the profile of prostate cancer in Dr. Sardjito General Hospital,  Yogyakarta,  Indonesia.  A  retrospective  study  involving  a  total  of  90  prostate cancer patients who underwent follow-up care at Dr. Sardjito General Hospital, Yogyakarta in the period of 2015 to 2020 was conducted. Data of the patients from their medical records consisted of age, gender, prostate volume, PSA  level,  testosterone  level,  hydronephrosis,  TURP  history,  histopathology  results,  Gleason  scores,  ISUP  grade,  and  staging  TNM  were  collected.  The  average of patients age was 67 ±10.4 y.o. where 22 (24.4%) patients aged 70 y.o. Almost of all patients (87 patients or 97.8%) were diagnosed as adenocarcinoma. Most of patients (73 patients or 81.4%) had prostate volume (TAUS) > 30 cm3 with the median at diagnosis was 51 cm3 (38.3 – 104.4). Furthermore, the median of PSA for diagnosis was 234.4 (94.4 – 1720.3) ng/mL and the median of testosterone level  at  diagnosis  was  317  (10  -  384)  ng/dL.  In  conclusion,  most  patients  with  prostate  cancer  are  identified  as  adenocarcinoma  with  metastatic  stage.  In  general, the prostate cancer patients age more than 61 years old with prostate volume  (TAUS)  >  30  cm3.  In  addition,  prostate  volume  and  testosterone  level  can be routinely used as initial screening and periodic assessment to evaluate prognosis and disease progression.
前列腺癌是男性恶性肿瘤中第四常见的非皮肤恶性肿瘤。在印度尼西亚,没有确切的数据报道,然而,Globocan报道前列腺癌在2018年排名第五。这种癌症的早期诊断和治疗与降低死亡率有关。本研究旨在调查印度尼西亚日惹Sardjito医生总医院前列腺癌的概况。一项回顾性研究涉及2015年至2020年期间在日惹Dr. Sardjito总医院接受随访治疗的90名前列腺癌患者。收集患者病历资料,包括年龄、性别、前列腺体积、PSA水平、睾酮水平、肾积水、TURP病史、组织病理学结果、Gleason评分、ISUP分级、TNM分期。患者平均年龄为67±10.4岁,70岁22例(24.4%),几乎所有患者(87例,97.8%)诊断为腺癌。大多数患者(73例,81.4%)前列腺体积(TAUS) > 30 cm3,诊断时中位数为51 cm3(38.3 - 104.4)。此外,诊断时PSA中位数为234.4 (94.4 - 1720.3)ng/mL,诊断时睾酮水平中位数为317 (10 - 384)ng/dL。总之,大多数前列腺癌患者被确定为转移期腺癌。前列腺癌患者年龄一般大于61岁,前列腺体积(TAUS) > 30 cm3。此外,前列腺体积和睾酮水平可作为常规的初始筛查和定期评估,以评估预后和疾病进展。
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引用次数: 0
Resistin associated with higher cardiovascular events in intermediate grace score of acute coronary syndrome 抵抗素与急性冠状动脉综合征中较高心血管事件相关
Pub Date : 2021-07-01 DOI: 10.19106/jmedsci005303202105
R. A. Gumilang, N. Taufiq, B. Setianto
Previous studies revealed that inflammatory biomarkers have a role in the clinical outcomes of acute coronary syndromes (ACS) and also in prediction of cardiovascular events using GRACE score. Resistin, a recently identified inflammatory biomarker, also has a role in clinical outcomes of ACS but its role related to GRACE score risk stratification is unknown. Three risk stratifications of ACS based on GRACE scores were used i.e. low, intermediate, and high.  Some studies reported that inflammatory biomarkers have a role in cardiovascular events of patients with low risk GRACE scores, but their role in the patients with intermediate risk still needs to be elucidated. This study aimed to investigate the role of resistin in cardiovascular events of ACS patients with intermediate risk GRACE score. This was an observational study using a cross-sectional design involving sixty-three patients with ACS who fulfilled the inclusion and exclusion criteria. Blood samples were drawn 24 h after onset. Resistin level was analyzed and classified according to its median values. The cardiovascular event was defined as mortality, ischemic events, acute heart failure or arrhythmia during hospitalization. The result showed that cardiovascular events were significantly higher in patients with resistin levels higher than median i.e. 23.8% compared to those with resistin levels similar or lower than median i.e. 11.1% (OR 3.348, 95%CI: 1.125-10.007 p=0.027). It can be concluded high resistin level is associated with an increase of cardiovascular events of ACS with intermediate risk GRACE score.
先前的研究表明,炎症生物标志物在急性冠状动脉综合征(ACS)的临床结果中发挥作用,并且使用GRACE评分预测心血管事件。抵抗素是最近发现的一种炎症生物标志物,在ACS的临床结果中也有作用,但其与GRACE评分风险分层的关系尚不清楚。采用基于GRACE评分的ACS风险分层,即低、中、高。一些研究报道炎症生物标志物在低风险GRACE评分患者的心血管事件中有作用,但它们在中等风险患者中的作用仍有待阐明。本研究旨在探讨抵抗素在GRACE评分中危ACS患者心血管事件中的作用。这是一项观察性研究,采用横断面设计,纳入63例符合纳入和排除标准的ACS患者。发病24 h后抽血。根据抵抗素水平的中位数进行分析和分类。心血管事件定义为住院期间的死亡率、缺血性事件、急性心力衰竭或心律失常。结果显示,抵抗素水平高于中位数的患者心血管事件发生率为23.8%,而抵抗素水平接近或低于中位数的患者心血管事件发生率为11.1% (or 3.348, 95%CI: 1.125 ~ 10.007 p=0.027)。由此可见,高抵抗素水平与中等危险GRACE评分ACS患者心血管事件增加相关。
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引用次数: 0
Infant appendicitis with perforation: a case report 婴儿阑尾炎伴穿孔1例
Pub Date : 2021-07-01 DOI: 10.19106/jmedsci005303202110
Fuad Adi Prasetyo, Ekvan Danang Setya, S. Supangat
Appendicitis is one of the most common surgical emergencies in children. In the USA, there are 70,000 cases are diagnosed each year. Acute appendicitis is a rare case, barely considered in the diagnoses, and probably causes acute abdominal sepsis in neonates. It affects males generally 75% of the time and 25%-50% of all reported cases occur in premature infant. Almost 50 cases have been reported over the last 30 years. We reported a 5 month-old baby girl whom transferred to our hospital from a peripheral hospital. Previously, the baby diagnosis was low-type obstruction. At the time of admission to our hospital, the baby presented with a history of abdominal distension and did not pass stools after 48 h. Oxygen and oral gastric tube were administered. Exploratory laparotomy surgery was performed through a transverse incision. This report is a retrospective review of one patient with appendicitis perforation presented in our hospital.
阑尾炎是儿童最常见的外科急症之一。在美国,每年有7万例确诊病例。急性阑尾炎是一种罕见的病例,在诊断中很少被考虑,并且可能导致新生儿急性腹部败血症。它通常在75%的情况下影响男性,所有报告病例的25%-50%发生在早产儿中。在过去的30年里,已经报告了近50例病例。我们报告一例5个月大的女婴从周边医院转至我院。此前,婴儿诊断为低类型梗阻。入院时患儿有腹胀史,48 h后未排便。给予吸氧及口服胃管。剖腹探查手术通过横向切口进行。本报告是对我院一例阑尾炎穿孔患者的回顾性分析。
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引用次数: 0
Prevalence of hypertension and its risk factors among obese adolescents in Yogyakarta, Indonesia 印度尼西亚日惹市肥胖青少年高血压患病率及其危险因素
Pub Date : 2021-07-01 DOI: 10.19106/jmedsci005303202103
Neti Nurani, Navilah Hidayati, Delvira Anggraini, Nurkharisma Kusumawardani, R. Palupi-Baroto
Obesity and overweight are considerable health problems with increasing prevalence among adolescents. In Indonesia, basic health research data from Riskesdas shows an increase in the prevalence of obesity in adolescents aged 13- 15 y.o, from 2.6% in 2010 to 6.7% in 2013. This high prevalence of overweight and obesity is related to various factors. This study aimed to determine the factors associated with hypertension and obesity in adolescents. This study was conducted on an overweight population, obese, and super-obese adolescents aged 13-15 year in the Yogyakarta City, Indonesia. Demographic data included the history of breastfeeding, birth weight, gender, history of premature birth, lifestyle, and physical activity were gathered. Anthropometric data included the weight, height, and body mass index (BMI) were also measured and gathered. Hypertension was measured using a manual sphygmomanometer. The relationship was analyzed using Pearson chi-square and the risk value was demonstrated from the odds ratio (OR). A significant relationship between gender and diastolic hypertension was observed (OR= 2.4; 95%CI = 1.23 – 5.09; p 0.05). in conclusion, there is a relationship between gender and diastolic hypertension incidence among obese adolescents. Boys are more at risk of obesity compared to girls.
肥胖和超重是相当严重的健康问题,在青少年中越来越普遍。在印度尼西亚,来自Riskesdas的基本健康研究数据显示,13- 15岁青少年的肥胖率从2010年的2.6%上升到2013年的6.7%。超重和肥胖的高发与多种因素有关。本研究旨在确定与青少年高血压和肥胖相关的因素。本研究针对印度尼西亚日惹市13-15岁的超重、肥胖和超肥胖青少年进行。人口统计数据包括母乳喂养史、出生体重、性别、早产史、生活方式和身体活动。人体测量数据包括体重、身高和身体质量指数(BMI)也被测量和收集。使用手动血压计测量高血压。使用皮尔逊卡方分析关系,并通过比值比(OR)证明风险值。性别与舒张期高血压有显著相关性(OR= 2.4;95%ci = 1.23 - 5.09;p 0.05)。综上所述,肥胖青少年的舒张期高血压发病率与性别有关。男孩比女孩更容易肥胖。
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引用次数: 0
Risk factors of sensory hearing loss in nasopharyngeal carcinoma patients obtaining conventional radiotherapy 鼻咽癌常规放疗患者感觉性听力丧失的危险因素分析
Pub Date : 2021-07-01 DOI: 10.19106/jmedsci005303202106
Odhi Anggani, S. R. Indrasari, Feri Trihandoko, A. Khoiria, A. Prasetyo
Previous studies proven that cochlear hair cells’ death plays an important role in sensorineural hearing loss due to radiation exposure. Other studies compared the differences between the impact of conventional radiotherapy (CRT) and intensity modulated radiation therapy (IMRT) on hearing loss in patients with nasopharyngeal carcinoma. Although, few differences found in some clinical manifestation, however no statistical analysis had been carried out. The aim of study was to evaluate the risk of sensory hearing loss in nasopharyngeal carcinoma patients who received CRT compared to IMRT. A case control study was performed on nasopharyngeal carcinoma patients who received radiotherapy at Dr. Sardjito General Hospital, Yogyakarta. The result of DPOAE between NPC patients who received CRT and IMRT was compared in this study. Statistical analysis was performed using chi square test and multivariate analysis. The result showed that patients who received CRT significantly altered the risk for sensory hearing loss in the contralateral ear as much as 11.2 times according to the multivariate analysis (CI 95%: 2.2 – 56.6; p=0.004). In conclusion, the risk of sensory hearing loss in patients with nasopharyngeal carcinoma who received CRT is a greater compared to IMRT.
以往的研究证实,耳蜗毛细胞的死亡在辐射引起的感音神经性听力损失中起重要作用。其他研究比较了常规放疗(CRT)和强度调制放疗(IMRT)对鼻咽癌患者听力损失影响的差异。虽然在一些临床表现上发现了一些差异,但没有进行统计分析。本研究的目的是评估鼻咽癌患者接受CRT和IMRT后感觉性听力损失的风险。对在日惹Dr. Sardjito总医院接受放射治疗的鼻咽癌患者进行了病例对照研究。本研究比较了鼻咽癌患者接受CRT和IMRT的DPOAE结果。统计学分析采用卡方检验和多变量分析。结果显示,多因素分析显示,接受CRT治疗的患者可显著改变对侧耳感觉性听力损失的风险达11.2倍(CI 95%: 2.2 ~ 56.6;p = 0.004)。综上所述,接受CRT治疗的鼻咽癌患者发生感觉性听力损失的风险高于IMRT治疗。
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引用次数: 0
Predictive factors for recurrence in patients with Graves’ Disease following treatment with methimazole 甲巯咪唑治疗Graves病患者复发的预测因素
Pub Date : 2021-07-01 DOI: 10.19106/jmedsci005303202102
M. R. Ikhsan, R. B. Pramono, Hemi Sinorita, V. Susanti
Graves’ disease (GD) contributes for 60–80% of all hyperthyroidism. Methimazole is the first line drug and most commonly used as antithyroid drug (ATD). However, the relapse rate following ATD therapy is 40–50%. The aimed of this study was to evaluate long-term ATD treatments and to identify prognostic factors that contribute to GD recurrence. A total of 46 GD patients who referred to the Endocrinology Clinic, Dr. Sardjito General Hospital, Yogyakarta between January 2016 and December 2018 with thyrotropin receptor antibody (TRAb) tested and treated with methimazole were included in this study. Size of goiter was measured based on WHO grading system and eye syndrome based on NOSPEC score system. Patients were classified into recurrence and remission groups based on TRAb evaluation at 12 month following treatment. Result of thyroid hormone level (FT4) and subject characteristic as predictive factors observed at 3-, 6- and 12-month post- treatment were compared and analyzed. Among 46 patient involved in this study, 23 patients demonstrated remission of hyperthyroidism based on TRAb evaluation at 12-month. The size of thyroid at onset of disease in 30 (65%) patients was grade 2 or above (p<0.05). Free FT4 levels at the end of observation (12 month) was 1.9±0.6 ng/ dL in recurrent and 1.4±0.5 ng/dL in remission group (p<0.05). TRAb levels at early of study was higher in the recurrent group (p<0.05). Logistic regression analysis demonstrated that thyroid size, FT4 level, and TRAb at diagnosis were associated with recurrencies. In conclusion, GD patients with large thyroids size, high TRAb levels, and high FT4 level at the onset of disease tended to fail to respond to ATD and were associated with recurrence incidence.
格雷夫斯病(GD)占所有甲亢的60-80%。甲巯咪唑是一线药物,也是最常用的抗甲状腺药物。然而,ATD治疗后复发率为40-50%。本研究的目的是评估ATD的长期治疗,并确定导致GD复发的预后因素。2016年1月至2018年12月期间,共有46名GD患者转诊至日惹Sardjito总医院内分泌科诊所,接受促甲状腺素受体抗体(TRAb)检测并接受甲巯唑治疗。甲状腺肿大的大小根据WHO分级系统测量,眼综合征的大小根据NOSPEC评分系统测量。根据治疗后12个月的TRAb评估将患者分为复发组和缓解组。比较分析治疗后3个月、6个月和12个月甲状腺激素水平(FT4)和受试者特征作为预测因素的结果。在本研究的46例患者中,根据TRAb评估,23例患者在12个月时显示甲状腺功能亢进缓解。30例(65%)患者发病时甲状腺大小为2级及以上(p<0.05)。观察结束时(12个月),复发组游离FT4水平为1.9±0.6 ng/dL,缓解组游离FT4水平为1.4±0.5 ng/dL (p<0.05)。复发组研究早期TRAb水平较高(p<0.05)。Logistic回归分析显示,诊断时甲状腺大小、FT4水平和TRAb与复发有关。综上所述,发病时甲状腺体积大、TRAb水平高、FT4水平高的GD患者往往对ATD治疗无效,且与复发率相关。
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引用次数: 0
Exercise as part of anxiety coping management in the Covid-19 pandemic era 运动作为新冠肺炎大流行时期焦虑应对管理的一部分
Pub Date : 2021-07-01 DOI: 10.19106/jmedsci005303202109
Denny Agustiningsih, Rakhmat Ari Wibowo
Containment effort in the COVID-19 pandemic could disrupt circadian rhythms which play an essential role in the development of mood and anxiety disorders. Exercise is one of several recommendations for anxiety coping during the COVID-19 pandemic. However, not every person has a similar response to an exercise stimulus and gets the same optimal benefits. For the best exercise results, we must consider individual needs and capacities, including circadian rhythm, in determining the exercise dose. This review briefly summarizes the exercise’ mechanism as an anxiolytic through skeletal muscle-brain crosstalk and designing exercise program with the individual optimal dose as part of anxiety coping management in the COVID-19 pandemic situation, considering exercise as good stress and circadian rhythm.
COVID-19大流行的遏制措施可能会破坏昼夜节律,而昼夜节律在情绪和焦虑症的发展中起着至关重要的作用。锻炼是应对COVID-19大流行期间焦虑的几种建议之一。然而,并不是每个人对运动刺激都有相似的反应,并获得相同的最佳益处。为了获得最佳的运动效果,我们必须考虑个人的需求和能力,包括昼夜节律,以确定运动剂量。本文简要总结了运动作为抗焦虑药的机制,通过骨骼肌-脑串扰,设计个体最佳剂量的运动方案,作为COVID-19大流行情况下焦虑应对管理的一部分,考虑运动是良好的应激和昼夜节律。
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引用次数: 0
Complication of trans-rectal prostate biopsy based on Clavien index: 5 years of experience 基于Clavien指数的经直肠前列腺活检并发症:5年的经验
Pub Date : 2021-07-01 DOI: 10.19106/jmedsci005303202107
Adhitya Fajar Prasetya, J. Renaldo
Trans-rectal prostate biopsy has become the gold standard for early diagnosis of prostate cancer in developing countries. Despite its low risk, there are some post-procedural complications. The complications are classified by using a modified Clavien-Dindo system. The study aimed to recognize complications of trans-rectal prostate biopsy procedure by using Clavien- Dindo classification index. All patients undergoing trans-rectal prostate biopsy procedure in the Department of Urology, Dr. Soetomo General Hospital between January 2015-December 2019, were retrospectively analyzed in terms of post-procedural complaints, underlying comorbidities and ongoing additional examinations. The complaints were compiled into Clavien-Dindo classification. Univariate analysis of various predictors of post-procedural complications was also conducted. It was found 98 complication events from 400 patients (24.5%). Most complications were 1st degree (dysuria, hematuria, urinary retention, fever, rectal pain and bleeding, erectile dysfunction, and constipation).  In univariate analysis, positive results of urinary culture correlated to the emergence of post-procedural complications. In conclusion, the incidence of post-trans-rectal prostate biopsy complication in Dr. Soetomo General Hospital reached 24.5%. From all of the risk factors, positive urinary culture is related to the post-biopsy complication. Most complications are in the 1st grade of Clavien index, suggesting that the procedure is relatively safe and has a low risk
经直肠前列腺活检已成为发展中国家前列腺癌早期诊断的金标准。尽管其风险较低,但仍有一些术后并发症。使用改良的Clavien-Dindo系统对并发症进行分类。本研究旨在应用Clavien- Dindo分类指数识别经直肠前列腺活检手术并发症。回顾性分析2015年1月至2019年12月期间在Dr. Soetomo总医院泌尿外科接受经直肠前列腺活检手术的所有患者的术后投诉、潜在合并症和正在进行的额外检查。这些投诉被汇编成Clavien-Dindo分类。对术后并发症的各种预测因素也进行了单因素分析。400例患者发生并发症98例(24.5%)。大多数并发症为一级(排尿困难、血尿、尿潴留、发热、直肠疼痛和出血、勃起功能障碍和便秘)。在单变量分析中,尿培养阳性结果与术后并发症的出现相关。综上所述,Dr. Soetomo总医院经直肠前列腺活检术后并发症的发生率为24.5%。从所有危险因素来看,尿培养阳性与活检后并发症有关。大多数并发症为Clavien指数1级,提示该手术相对安全,风险低
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引用次数: 0
Centella asiatica : alternative dry skin therapy in type 2 diabetes mellitus 积雪草:替代干皮疗法治疗2型糖尿病
Pub Date : 2021-07-01 DOI: 10.19106/jmedsci005303202108
L. Legiawati
Diabetes mellitus (DM) in Indonesia has rapidly increased during recent years. World Health Organization (WHO) predicted that in 2030, Indonesia would be ranked fourth for the largest DM patients in the world. As the disease progresses, uncontrolled type 2 DM (T2DM) results in dry skin as the most prevalent skin disorder. Despite the prevalence and morbidities that lead to infection, ulcer, gangrene that can lead to amputation when insufficiently treated, dry skin in T2DM has limited therapeutic options. Currently, available therapies for dry skin in T2DM have not considered factors of hyperglycemia and hyperinsulinemia, which disturb skin homeostasis. Nonetheless, in T2DM, there are neuropathy and biostructural changes of the skin which induce dry skin. Alternative herbal medicine, Centella asiatica is getting well-known nowadays because of its vast amount of benefits. Centella asiatica has been studied for its antioxidant, antidiabetic, anti-inflammation, antiglycation, and neuroprotective activities. Furtherly, these properties may display benefits when introduced to T2DM dry skin therapy. The previous clinical study had shown that topical C. asiatica improved dry skin. This clinical study was also supported by in vitro studies. Currently, pharmacological profile studies of C. asiatica  including dosage, toxicity, and safety have been available. This article aimed to review the current literature on the potential of C. asiatica as an alternative to treat dry skin in T2DM.
近年来,印度尼西亚的糖尿病(DM)发病率迅速上升。世界卫生组织(WHO)预测,到2030年,印度尼西亚将成为糖尿病患者数量最多的世界第四大国家。随着病情的发展,不受控制的2型糖尿病(T2DM)导致皮肤干燥,成为最常见的皮肤病。尽管2型糖尿病的患病率和发病率可导致感染、溃疡和坏疽,如果治疗不当可导致截肢,但皮肤干燥患者的治疗选择有限。目前,针对2型糖尿病患者皮肤干燥的现有治疗方法尚未考虑到高血糖和高胰岛素血症的因素,这些因素会扰乱皮肤稳态。然而,在T2DM患者中,存在神经病变和皮肤生物结构改变,导致皮肤干燥。替代草药,积雪草是越来越知名的今天,因为它的巨大的好处。积雪草具有抗氧化、抗糖尿病、抗炎症、抗糖化和神经保护作用。此外,当引入T2DM干性皮肤治疗时,这些特性可能会显示出益处。以前的临床研究表明,局部的亚洲曲改善皮肤干燥。这项临床研究也得到了体外研究的支持。目前,对亚洲积雪草的药理学研究包括剂量、毒性和安全性。这篇文章旨在回顾目前的文献关于亚洲金曲作为治疗2型糖尿病皮肤干燥的替代方案的潜力。
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引用次数: 0
Congenital cystic adenomatoid malformation: a case report 先天性囊性腺瘤样畸形1例
Pub Date : 2021-07-01 DOI: 10.19106/jmedsci005303202111
Haryo Aribowo, D. A. Amelinda, Ghifari Farandhi
Congenital cystic adenomatoid malformation (CCAM) is a rare condition defined by multiple cysts produced in the lung that occur during the fetal period, with respiratory distress as presenting symptoms. Untreated CCAM may lead to repeated lung infection and pneumothorax. Many surgical techniques have been used to treat CCAM. However, those techniques showed various results. Moreover, less studies were performed to evaluate the effect of those surgical techniques in treating CCAM patients. We reported a management of  a rare pediatric case of CCAM referred to the Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital. The patient was a 29-day-old male baby who presented with pneumothorax on the right lung due to CCAM. The plan of treatment for the patient was lobectomy until pneumonectomy on the affected lung. During the thoracotomy procedure, we found that all lobes in the right lung were covered with fibrous tissue. Based on this finding, a decortication procedure to remove the fibrous tissue continued by a bullectomy procedure with the insertion of a chest tube were performed. The patient continuously showed improvement in breathing and wound healing, thus making the patient discharged from the hospital on the nineteenth postoperative day. The cause of CCAM is thought to be congenital abnormalities of the bronchiole epithelium that produce multiple cysts. Due to its rarity and lack of research on CCAM, many CCAM patients are misdiagnosed/ underdiagnosed. Common surgical methods used in this patient are lobectomy with continuation until pneumonectomy or bilobectomy, if necessary, to prevent recurrence. Parenchymal saving methods can be considered because they have the same outcome as lobectomy. As performed in this patient, thoracotomy decortication continued with bullectomy is adequately capable of alleviating respiratory distress symptoms and is thus described as successful.
先天性囊性腺瘤样畸形(CCAM)是一种罕见的疾病,在胎儿时期肺部产生多个囊肿,以呼吸窘迫为主要症状。未经治疗的CCAM可能导致反复肺部感染和气胸。许多外科技术已被用于治疗CCAM。然而,这些技术显示了不同的结果。此外,评估这些手术技术在治疗CCAM患者中的效果的研究较少。我们报告了一个罕见的小儿CCAM病例的处理,转介到Gadjah Mada大学医学、公共卫生和护理学院胸外科和心血管外科。萨吉托总医院。患者是一名29天大的男婴,由于CCAM而出现右肺气胸。患者的治疗方案为肺叶切除术,直至患肺全肺切除术。在开胸手术中,我们发现右肺的所有肺叶都被纤维组织覆盖。基于这一发现,我们进行了去除纤维组织的去皮手术,接着进行了胸管插入的大泡切除术。患者呼吸及伤口愈合持续改善,于术后第19天出院。CCAM的病因被认为是先天性细支气管上皮异常,产生多个囊肿。由于CCAM的罕见性和研究的缺乏,许多CCAM患者被误诊/漏诊。该患者常用的手术方法是肺叶切除术,继续至全肺切除术或胆叶切除术,如有必要,以防止复发。实质保存方法可以考虑,因为它们的结果与肺叶切除术相同。在本例患者中,开胸去皮术结合大泡切除术足以缓解呼吸窘迫症状,因此被认为是成功的。
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引用次数: 0
期刊
Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)
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