\u00c7ocukluk \u00e7a\u011f\u0131nda s\u0131k g\u00f6r\u00fclmesine ra\u011fmen \u00e7o\u011fu zaman belirti vermeden ilerleyen b\u00f6brek refl\u00fcs\u00fc, idrar\u0131n mesaneden b\u00f6breklere do\u011fru geri ka\u00e7mas\u0131yla ortaya \u00e7\u0131kan \u00f6nemli bir sa\u011fl\u0131k sorunudur. \u00d6zellikle s\u0131k idrara \u00e7\u0131kma, kar\u0131n a\u011fr\u0131s\u0131, tekrarlayan ate\u015fli idrar yolu enfeksiyonlar\u0131yla kendini g\u00f6sterebilen bu tablo, erken tan\u0131 konulmad\u0131\u011f\u0131nda kal\u0131c\u0131 b\u00f6brek hasar\u0131na yol a\u00e7abiliyor. Uzmanlar, \u00e7ocuklarda g\u00f6r\u00fclen idrar yolu enfeksiyonlar\u0131n\u0131n mutlaka dikkatle de\u011ferlendirilmesi gerekti\u011fini vurguluyor. Memorial G\u00f6ztepe Hastanesi \u00c7ocuk Cerrahisi B\u00f6l\u00fcm\u00fc\u2019nden Do\u00e7. Dr. Hakan Kocaman, \u00e7ocuklarda b\u00f6brek refl\u00fc hastal\u0131\u011f\u0131 ve tedavisi hakk\u0131nda bilgi verdi.<\/p>\n
\u0130drar ak\u0131\u015f\u0131 terse d\u00f6ner ve bakteriler b\u00f6breklere ula\u015f\u0131r<\/strong><\/p>\n Veziko\u00fcreteral refl\u00fc (VUR), idrar\u0131n normalde tek y\u00f6nl\u00fc olmas\u0131 gereken ak\u0131\u015f\u0131n\u0131n tersine d\u00f6nmesiyle ortaya \u00e7\u0131kan bir durumdur. Bu durum, bakterilerin b\u00f6breklere ula\u015fmas\u0131n\u0131 kolayla\u015ft\u0131rarak enfeksiyon riskini art\u0131r\u0131r. \u00d6zellikle bebeklik ve erken \u00e7ocukluk d\u00f6neminde g\u00f6r\u00fclen hastal\u0131k, \u00e7o\u011fu zaman belirgin \u015fik\u00e2yet olu\u015fturmadan ilerleyebilir.<\/p>\n 0-5 ya\u015f aras\u0131 \u00e7ocuklar en riskli grupta<\/strong><\/p>\n VUR a\u00e7\u0131s\u0131ndan en riskli grup 0-5 ya\u015f aras\u0131 \u00e7ocuklard\u0131r. Erkek bebeklerde ya\u015fam\u0131n ilk y\u0131l\u0131nda daha s\u0131k g\u00f6r\u00fcl\u00fcrken, k\u0131z \u00e7ocuklar\u0131nda genellikle tekrarlayan enfeksiyonlarla ortaya \u00e7\u0131kmaktad\u0131r. Ailesinde refl\u00fc \u00f6yk\u00fcs\u00fc olanlar, do\u011fumsal idrar yolu anomalisi bulunan \u00e7ocuklar ile kab\u0131zl\u0131k ve i\u015feme bozuklu\u011fu ya\u015fayanlar da risk grubunda yer al\u0131r. Hastal\u0131\u011f\u0131n en yayg\u0131n nedeni do\u011fumsal fakt\u00f6rlerdir. \u00dcreterin mesaneye giri\u015f yerindeki kapak mekanizmas\u0131n\u0131n yeterince geli\u015fmemesi refl\u00fcye yol a\u00e7abilir. Bunun yan\u0131 s\u0131ra mesane \u00e7\u0131k\u0131\u015f\u0131nda t\u0131kan\u0131kl\u0131k, n\u00f6rojen mesane, posterior \u00fcretral valv gibi yap\u0131sal sorunlar ya da uzun s\u00fcreli i\u015feme disfonksiyonlar\u0131 da hastal\u0131\u011f\u0131n geli\u015fmesine neden olabilir.<\/p>\n Bu belirtiler \u00e7ocuklarda b\u00f6brek refl\u00fcs\u00fcne i\u015faret edebilir!<\/strong><\/p>\n Tekrarlayan idrar yolu enfeksiyonlar\u0131 ve \u00f6zellikle ate\u015fli enfeksiyonlar en \u00f6nemli i\u015faretler aras\u0131nda yer al\u0131r. Bir ya\u015f alt\u0131 bebeklerde nedeni a\u00e7\u0131klanamayan y\u00fcksek ate\u015f, gebelikte saptanan b\u00f6brek geni\u015flemesi ve ailede refl\u00fc \u00f6yk\u00fcs\u00fc bulunmas\u0131 da dikkate al\u0131nmal\u0131d\u0131r. Ayr\u0131ca b\u00fcy\u00fcme gerili\u011fi ve \u00e7ocukluk \u00e7a\u011f\u0131nda g\u00f6r\u00fclen hipertansiyon da de\u011ferlendirilmesi gereken di\u011fer \u00f6nemli bulgulard\u0131r.<\/p>\n Hastal\u0131k \u00e7o\u011fu zaman do\u011frudan belirti vermese de idrar yolu enfeksiyonu s\u0131ras\u0131nda baz\u0131 \u015fik\u00e2yetlerle kendini g\u00f6sterebilir. Bebeklerde y\u00fcksek ate\u015f, huzursuzluk, beslenme g\u00fc\u00e7l\u00fc\u011f\u00fc, kusma ve kilo alamama g\u00f6r\u00fclebilir. Daha b\u00fcy\u00fck \u00e7ocuklarda ise s\u0131k ve a\u011fr\u0131l\u0131 idrara \u00e7\u0131kma, kar\u0131n veya bel a\u011fr\u0131s\u0131, k\u00f6t\u00fc kokulu ya da bulan\u0131k idrar ve gece alt \u0131slatma gibi belirtiler \u00f6n plana \u00e7\u0131kabilir.<\/p>\n B\u00f6brek hasar\u0131 varsa cerrahi g\u00fcndeme gelebilir<\/strong><\/p>\n Veziko\u00fcreteral refl\u00fcn\u00fcn en b\u00fcy\u00fck riski, yol a\u00e7t\u0131\u011f\u0131 enfeksiyonlar ve buna ba\u011fl\u0131 geli\u015fen b\u00f6brek hasar\u0131d\u0131r. Tan\u0131 i\u00e7in ilk basamak genellikle ultrasonografidir. Kesin tan\u0131 ise \u201ci\u015feme sisto\u00fcretrografisi\u201d (VCUG) ile konur ve bu y\u00f6ntemle refl\u00fcn\u00fcn derecesi belirlenir. Gerekli durumlarda b\u00f6breklerde kal\u0131c\u0131 hasar olup olmad\u0131\u011f\u0131n\u0131 de\u011ferlendirmek i\u00e7in b\u00f6brek sintigrafisi de yap\u0131labilir.<\/p>\n Tedavi s\u00fcreci her \u00e7ocuk i\u00e7in bireysel olarak planlanmal\u0131d\u0131r. \u00c7\u00fcnk\u00fc refl\u00fcn\u00fcn derecesi, \u00e7ocu\u011fun ya\u015f\u0131, enfeksiyon s\u0131kl\u0131\u011f\u0131 ve b\u00f6breklerde hasar olup olmamas\u0131 en \u00f6nemli belirleyici unsurlard\u0131r. D\u00fc\u015f\u00fck dereceli refl\u00fclerin \u00f6nemli bir k\u0131sm\u0131 zamanla kendili\u011finden d\u00fczelebilmektedir. Hafif vakalarda d\u00fczenli takip ve enfeksiyonlardan korunma yeterli olabilirken, orta dereceli olgularda endoskopik y\u00f6ntemler tercih edilebilir. \u0130leri dereceli ve b\u00f6brek hasar\u0131 riski bulunan durumlarda ise cerrahi tedavi g\u00fcndeme gelebilir.\u00a0<\/p>\n \u00a0<\/strong><\/p>\n \u00a0<\/p>\n Kaynak: (BYZHA) Beyaz Haber Ajans\u0131<\/p>\n","protected":false},"excerpt":{"rendered":" \u00c7ocukluk \u00e7a\u011f\u0131nda s\u0131k g\u00f6r\u00fclmesine ra\u011fmen \u00e7o\u011fu zaman belirti vermeden ilerleyen b\u00f6brek refl\u00fcs\u00fc, idrar\u0131n mesaneden b\u00f6breklere do\u011fru geri ka\u00e7mas\u0131yla ortaya \u00e7\u0131kan \u00f6nemli bir sa\u011fl\u0131k sorunudur.<\/p>\n","protected":false},"author":1,"featured_media":6077,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[31],"tags":[],"class_list":["post-6076","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-saglik"],"_links":{"self":[{"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=\/wp\/v2\/posts\/6076","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6076"}],"version-history":[{"count":1,"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=\/wp\/v2\/posts\/6076\/revisions"}],"predecessor-version":[{"id":6078,"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=\/wp\/v2\/posts\/6076\/revisions\/6078"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=\/wp\/v2\/media\/6077"}],"wp:attachment":[{"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6076"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6076"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ekonomievreni.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6076"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}