![](\"http:\/\/www.erzurumflas.com\/wp-content\/uploads\/2015\/11\/koah-tedavi-edilebilir-bir-hastaliktir_fcb1263.jpg\")
Ac\u0131badem Ankara Hastanesi G\u00f6\u011f\u00fcs Hastal\u0131klar\u0131 Uzman\u0131 Do\u00e7. Dr. Ay\u015fe Y\u0131lmaz, D\u00fcnya KOAH G\u00fcn\u00fc nedeniyle, “Sigara i\u00e7en her be\u015f alt\u0131 ki\u015fiden birinde KOAH geli\u015fmektedir. D\u00fcnya\u2019da ve T\u00fcrkiye\u2019de 210 milyon KOAH oldu\u011fu ve bunlar\u0131n b\u00fcy\u00fck bir b\u00f6l\u00fcm\u00fcn\u00fcn tan\u0131 almad\u0131\u011f\u0131 (y\u00fczde 70-90) tahmin edilmektedir” dedi.<\/p>\n
Ac\u0131badem Ankara Hastanesi G\u00f6\u011f\u00fcs Hastal\u0131klar\u0131 Uzman\u0131 Do\u00e7. Dr. Ay\u015fe Y\u0131lmaz, 18 Kas\u0131m D\u00fcnya KOAH G\u00fcn\u00fc nedeniyle, hastal\u0131\u011f\u0131n sebepleri, nedenleri ve tedavisi ile ilgili a\u00e7\u0131klama yapt\u0131.<\/p>\n
KOAH hastal\u0131\u011f\u0131n\u0131n, uzun s\u00fcredir hava yollar\u0131nda t\u0131kanmaya neden olan, ilerleyici ve tam olarak geri d\u00f6n\u00fc\u015f\u00fcm\u00fc olmayan, fakat \u00f6nlenebilir ve tedavi edilebilir bir akci\u011fer hastal\u0131\u011f\u0131 oldu\u011funa dikkat \u00e7eken Y\u0131lmaz, \u201cKOAH hastal\u0131\u011f\u0131 \u00f6zellikle sigara duman\u0131 ve di\u011fer zararl\u0131 gaz ve par\u00e7ac\u0131klara ba\u011fl\u0131 olarak geli\u015fen hava yollar\u0131n\u0131n mikrobik olmayan iltihab\u0131d\u0131r. KOAH tan\u0131m\u0131 i\u00e7inde \u2019kronik bron\u015fit\u2019 ve \u2019amfizem\u2019 birlikte yer al\u0131rlar. Hava yollar\u0131nda daralma ile birlikte akci\u011ferin en k\u00fc\u00e7\u00fck birimi olan ve kana oksijen ta\u015f\u0131nmas\u0131n\u0131 sa\u011flayan hava keseciklerindeki harabiyete ba\u011fl\u0131 olarak normalde balon gibi esnek olan geni\u015fleyip-daralabilen hava yollar\u0131 bu \u00f6zelli\u011fini yani elastikiyetini yitirirler. Geni\u015flemi\u015f hava keseciklerine giren havan\u0131n \u00e7\u0131kmas\u0131 zorla\u015f\u0131r, daha da \u015fi\u015fer. Bu bulgular \u2019amfizem\u2019 olarak adland\u0131r\u0131l\u0131r. KOAH\u2019ta ayr\u0131ca k\u00fc\u00e7\u00fck hava yollar\u0131 mikrobik olmayan iltihap nedeniyle \u015fi\u015fer, balgam \u00fcreten bezlerin a\u015f\u0131r\u0131 \u00e7al\u0131\u015fmas\u0131 nedeniyle balgam miktar\u0131 artar. Daralan hava yollar\u0131ndan havan\u0131n ge\u00e7i\u015fi g\u00fc\u00e7le\u015fir. Bu bulgular ise \u2019kronik bron\u015fit\u2019 olarak adland\u0131r\u0131l\u0131r ve en az iki y\u0131l \u00fcst \u00fcste ve bu iki y\u0131l\u0131n en az \u00fc\u00e7 ay\u0131nda \u00f6ks\u00fcr\u00fck ve balgamla seyreden ilerleyici bir rahats\u0131zl\u0131k olarak tan\u0131mlan\u0131r\u201d ifadelerini kulland\u0131.<\/p>\n
KOAH\u2019\u0131n g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131n\u0131n 40 ya\u015f \u00fcst\u00fc yeti\u015fkinlerde y\u00fczde 15-20 oldu\u011funu belirten Do\u00e7. Dr. Y\u0131lmaz, \u201cSigara i\u00e7en her be\u015f alt\u0131 ki\u015fiden birinde KOAH geli\u015fmektedir. D\u00fcnyada ve T\u00fcrkiye\u2019de 210 milyon KOAH oldu\u011fu ve bunlar\u0131n b\u00fcy\u00fck bir b\u00f6l\u00fcm\u00fcn\u00fcn tan\u0131 almad\u0131\u011f\u0131 (y\u00fczde 70-90) tahmin edilmektedir. \u00dclkemizde tahminen 3-5 milyon KOAH\u2019l\u0131 hasta vard\u0131r, bu hastalar\u0131n sadece 300-500 bini kendisinde hastal\u0131k oldu\u011funu bilmektedir. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc verilerine g\u00f6re t\u00fcm d\u00fcnyada KOAH en \u00f6nemli 4. \u00f6l\u00fcm nedenidir, y\u0131lda 2,9 milyon ki\u015finin \u00f6l\u00fcm\u00fcne neden olmaktad\u0131r ve t\u00fcm \u00f6l\u00fcmlerin y\u00fczde 5.5\u2019inden sorumludur. \u00dclkemizde \u00f6l\u00fcm nedenleri aras\u0131nda KOAH 3. s\u0131radad\u0131r ve her y\u0131l bu hastal\u0131ktan 26 bin ki\u015fi \u00f6lmektedir\u201d dedi.<\/p>\n
Hastal\u0131\u011f\u0131n nedenlerini s\u0131ralayan Y\u0131lmaz, a\u00e7\u0131klamalar\u0131na \u015f\u00f6yle devam etti:<\/p>\n
\u201cHastal\u0131\u011f\u0131n en \u00f6nemli nedeni sigara ba\u011f\u0131ml\u0131l\u0131\u011f\u0131d\u0131r. \u00dclkemizde eri\u015fkinlerin yakla\u015f\u0131k yar\u0131s\u0131 sigara i\u00e7mektedir ve son y\u0131llarda kad\u0131nlarda sigara i\u00e7iminin yayg\u0131nla\u015fmas\u0131yla kad\u0131nlarda da KOAH h\u0131zla artmaktad\u0131r. Ki\u015finin sigaraya ba\u015flama ya\u015f\u0131, g\u00fcnl\u00fck ve toplam i\u00e7ilen miktar ve duman\u0131n yo\u011funlu\u011fu hastal\u0131\u011f\u0131n geli\u015fimini etkilemektedir. Otuz ya\u015f\u0131ndan sonra akci\u011fer kapasitesi her y\u0131l azalmaya ba\u015flar. Sigara i\u00e7enlerde bu oran \u00e7ok daha fazlad\u0131r; ancak sigaran\u0131n b\u0131rak\u0131lmas\u0131 ile bu azalma yava\u015flamaktad\u0131r. KOAH geli\u015fiminden y\u00fczde 80-90 oran\u0131nda sigara i\u00e7iminin sorumlu oldu\u011fu ve sigara i\u00e7meyenlere g\u00f6re hastal\u0131\u011f\u0131n geli\u015fme riskinin 9,7-30 kat artt\u0131\u011f\u0131 rapor edilmi\u015ftir. Pipo ve puro i\u00e7imi de risklidir. Sigara i\u00e7meyenlerin, \u00f6zellikle de anne ve babas\u0131 sigara i\u00e7en \u00e7ocuklar\u0131n sigara duman\u0131na maruz kalmas\u0131yla bu ki\u015filerde ileri ya\u015flarda ast\u0131m ve KOAH ba\u015fta olmak \u00fczere solunum sistemi hastal\u0131klar\u0131 daha \u00e7ok g\u00f6r\u00fcl\u00fcr. Baz\u0131 \u00e7evresel ve genetik fakt\u00f6rler hastal\u0131k geli\u015fiminde etkilidir. \u0130\u015f yerindeki meslek nedeniyle organik-inorganik toz, duman ve \u00e7e\u015fitli gazlar\u0131n solunmas\u0131 (maden, metal, odun, ka\u011f\u0131t imalat\u0131, \u00e7imento, tah\u0131l ve tekstil i\u015f\u00e7ili\u011fi vs.), kimyasal maddeler ve \u00fclkemizde \u00f6zellikle sigara i\u00e7meyen kad\u0131nlarda iyi havalanmayan evlerde \u0131s\u0131nma ya da yemek pi\u015firme amac\u0131yla \u00e7al\u0131, \u00e7\u0131rp\u0131, odun ya da tezek yakmak ve bunlar\u0131n duman\u0131na maruz kalmak i\u00e7 ortam hava kirlili\u011fine ve KOAH\u2019a yol a\u00e7abilir. Kentlerdeki hava kirlili\u011fi hem KOAH\u2019a hem de bu hastal\u0131\u011f\u0131n alevlenmesine neden olur. Hastalar\u0131n yakla\u015f\u0131k y\u00fczde 1\u2019inden az bir k\u0131sm\u0131nda genetik nedenler sorumlu olabilir. D\u00fc\u015f\u00fck sosyoekonomik ko\u015fullarda ya\u015fayanlarda akci\u011fer fonksiyonlar\u0131 daha d\u00fc\u015f\u00fck oldu\u011fundan KOAH geli\u015fimi h\u0131zl\u0131d\u0131r. A, C, E vitamini eksikli\u011fi ve alkol kullan\u0131m\u0131 da KOAH geli\u015fiminde rol oynayabilmektedir.\u201d<\/p>\n
Nefes darl\u0131\u011f\u0131 veya kronik \u00f6ks\u00fcr\u00fck ve balgam \u00e7\u0131karma gibi \u015fikayetlerle KOAH hastal\u0131\u011f\u0131n\u0131n ortaya \u00e7\u0131kt\u0131\u011f\u0131n\u0131 ifade eden Y\u0131lmaz, \u201cHastal\u0131\u011f\u0131n ilk a\u015famalar\u0131nda ortaya \u00e7\u0131kan \u00f6ks\u00fcr\u00fck yak\u0131nmas\u0131 asl\u0131nda hastal\u0131\u011f\u0131n ilk belirtisi olmas\u0131na ra\u011fmen genellikle sigara i\u00e7imine ba\u011flan\u0131r. Hastal\u0131k asl\u0131nda bu ilk a\u015famada saptanabilirse ilerlemesi durdurulabilir. Nefes darl\u0131\u011f\u0131 hastal\u0131\u011f\u0131n erken d\u00f6nemlerinde h\u0131zl\u0131 y\u00fcr\u00fcme veya merdiven \u00e7\u0131kma gibi eforlar ile ortaya \u00e7\u0131karken hastal\u0131\u011f\u0131n ilerlemesi ile d\u00fcz yolda ve istirahat halinde nefes darl\u0131\u011f\u0131 olu\u015fur; k\u0131\u015f aylar\u0131nda ve \u00f6zellikle hava kirlili\u011finin yo\u011fun oldu\u011fu d\u00f6nemlerde ve gribal enfeksiyonlar sonras\u0131nda bu yak\u0131nmalar artar. Nefes darl\u0131\u011f\u0131 nedeniyle fizik aktivitede azal\u0131r ve hastan\u0131n ya\u015fam kalitesi bozulur. Bu hastal\u0131\u011f\u0131n \u00f6nlenmesi ve ilerlemesinin engellenmesinde fiziksel aktivitenin artt\u0131r\u0131lmas\u0131 gerekmektedir. Ki\u015fi, hastal\u0131k ilerledik\u00e7e artan nefes darl\u0131\u011f\u0131ndan dolay\u0131 g\u00fcnl\u00fck i\u015flerini kendi ba\u015f\u0131na yapamayabilir ve ba\u015fkalar\u0131n\u0131n deste\u011fine ihtiya\u00e7 duyabilir. Bu hastalarda g\u00f6\u011f\u00fcste t\u0131kanma olabilir ve nefes al\u0131p vermeleri s\u0131ras\u0131nda h\u0131r\u0131lt\u0131\/h\u0131\u015f\u0131rt\u0131ya benzer bir ses etraftan duyulabilir. Bazen balgamla birlikte kan gelebilir. Nefes darl\u0131\u011f\u0131na ba\u011fl\u0131 uyku, beslenme bozulabilir ve harcanan enerjinin artmas\u0131yla hasta kilo kaybeder ve zay\u0131flayabilir. Hastal\u0131\u011f\u0131n ileri d\u00f6nemlerinde oksijen yetersizli\u011fine ba\u011fl\u0131 morarma, a\u015f\u0131r\u0131 yorgunluk, g\u00fc\u00e7s\u00fczl\u00fck, kalp yetersizli\u011fine ba\u011fl\u0131 bacaklarda \u015fi\u015fme ve kalpte ritm bozukluklar\u0131 g\u00f6r\u00fclebilir” diye konu\u015ftu.<\/p>\n
KOAH\u2019\u0131n tan\u0131s\u0131, basit bir test olan \u201cnefes \u00f6l\u00e7\u00fcm testi\u201d ile kolayca konabilece\u011fini belirten Y\u0131lmaz, \u201cKOAH\u2019\u0131n erken tan\u0131s\u0131, hastal\u0131\u011fa ba\u011fl\u0131 sakatl\u0131k ve \u00f6l\u00fcm oranlar\u0131n\u0131 azaltacakt\u0131r. Sigara i\u00e7iminin b\u0131rak\u0131lmas\u0131, KOAH\u2019\u0131n geli\u015fme ve ilerleme riskini azaltan ve hastal\u0131\u011f\u0131n ilerlemesini durduran tek ve en etkili giri\u015fimdir. Sigara ba\u011f\u0131ml\u0131l\u0131\u011f\u0131 tedavi edilebilen bir hastal\u0131kt\u0131r. Sigara i\u00e7icilerin 40-50\u2019li ya\u015flarda sigaray\u0131 b\u0131rakmalar\u0131 durumunda, akci\u011fer fonksiyonlar\u0131ndaki kay\u0131p k\u0131smen d\u00fczelmektedir. Di\u011fer \u00e7evresel ve mesleki zararl\u0131 toz ve dumandan uzak durulmas\u0131, grip ve zat\u00fcrre a\u015f\u0131lar\u0131n\u0131n yap\u0131lmas\u0131 ve nefes yoluyla al\u0131nan ila\u00e7 tedavisinin yan\u0131 s\u0131ra fiziksel aktivitenin art\u0131r\u0131lmas\u0131 hem hastal\u0131k geli\u015fimi, hem hastal\u0131\u011f\u0131n ilerlemesi ve k\u00f6t\u00fc sonu\u00e7lar\u0131n\u0131n \u00f6nlenmesinde \u00e7ok \u00f6nemlidir. Haftan\u0131n en az 5 g\u00fcn\u00fc ve g\u00fcnde en az 30 dakika kadar orta yo\u011funluktaki bir fiziksel aktivite, \u00f6rne\u011fin y\u00fcr\u00fcy\u00fc\u015f yeterli olacakt\u0131r. Hastal\u0131\u011f\u0131n derecesine g\u00f6re t\u0131bbi tedavi belirlenir. Akci\u011ferlere giden hava miktar\u0131n\u0131 artt\u0131rmay\u0131 sa\u011flayan ila\u00e7lar ve hastal\u0131\u011f\u0131n a\u011f\u0131rl\u0131\u011f\u0131na g\u00f6re eklenen inhaler steroidler ile hastal\u0131\u011f\u0131n uzun s\u00fcreli tedavisi yap\u0131l\u0131r. A\u011f\u0131r ve \u00e7ok a\u011f\u0131r KOAH\u2019l\u0131 olgularda solunum yetmezli\u011fi geli\u015fti\u011finde hastalar\u0131n \u00f6zelikle geceleri, uyku ve efor s\u0131ras\u0131nda olmak \u00fczere en az 15-18 saat s\u00fcre ile oksijen almalar\u0131 gerekir. KOAH tedavisinde, hastal\u0131k alevlenmelerinin \u00f6nlenmesi de ama\u00e7lanmaktad\u0131r. Alevlenme, hastan\u0131n solunum yolu \u015fikayetlerinde g\u00fcnl\u00fck g\u00f6zlenen normal de\u011fi\u015fikli\u011fin \u00f6tesinde ila\u00e7 de\u011fi\u015fikli\u011fine yol a\u00e7an bir k\u00f6t\u00fcle\u015fme olarak tan\u0131mlanmaktad\u0131r. Ayr\u0131ca KOAH\u2019l\u0131 hastalarda y\u00fcksek tansiyon, kalp yetmezli\u011fi, kalp damar hastal\u0131\u011f\u0131 ve \u015feker hastal\u0131klar\u0131n tan\u0131lar\u0131n\u0131n konmas\u0131 ve tedavilerinin yap\u0131lmas\u0131 gerekir\u201d dedi.<\/p>\n
\u2018Hastalar genellikle nefes darl\u0131\u011f\u0131 ilerledi\u011finde ba\u015fvurduklar\u0131ndan tan\u0131 ve tedavide genellikle ge\u00e7 kal\u0131nm\u0131\u015f olur\u2019 diyen Y\u0131lmaz, \u015f\u00f6yle devam etti:<\/p>\n
\u201cBu nedenle 40 ya\u015f \u00fcst\u00fc, sigara i\u00e7mi\u015f ya da i\u00e7mekte olan ve meslek nedeniyle ya da \u00e7evresel ortam gere\u011fi tozlu ortamlarda bulunan ki\u015filerde uzun s\u00fcreli \u00f6ks\u00fcr\u00fck, balgam ve nefes darl\u0131\u011f\u0131 yak\u0131nmalar\u0131ndan en az birinin bulunmas\u0131 halinde ki\u015finin bir g\u00f6\u011f\u00fcs hastal\u0131klar\u0131 hekimi taraf\u0131ndan g\u00f6r\u00fcl\u00fcp \u2019nefes \u00f6l\u00e7\u00fcm testi (spirometri=solunum fonksiyon testi)\u2019 yapt\u0131rmas\u0131 gerekir. \u00c7\u00fcnk\u00fc hastal\u0131\u011f\u0131n erken te\u015fhisi ve ilerlemesinin \u00f6nlenmesi a\u00e7\u0131s\u0131ndan sigaran\u0131n b\u0131rak\u0131lmas\u0131 \u00f6nemlidir.”<\/p>\n","protected":false},"excerpt":{"rendered":"
ACIBADEM ANKARA HASTANES\u0130 G\u00d6\u011e\u00dcS HASTALIKLARI UZMANI DO\u00c7. DR. AY\u015eE YILMAZ, 18 KASIM D\u00dcNYA KOAH G\u00dcN\u00dc NEDEN\u0130YLE, HASTALI\u011eIN SEBEPLER\u0130, NEDENLER\u0130 VE TEDAV\u0130S\u0130 \u0130LE \u0130LG\u0130L\u0130 A\u00c7IKLAMA YAPTI.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14,20],"tags":[13083,26712,26713,12772,6926],"class_list":["post-144454","post","type-post","status-publish","format-standard","hentry","category-saglik","category-turkiye","tag-bir","tag-edilebilir","tag-hastaliktir","tag-koah","tag-tedavi"],"_links":{"self":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/posts\/144454","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=144454"}],"version-history":[{"count":0,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/posts\/144454\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=144454"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=144454"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=144454"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}