Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Lepra Hastalarındaki El, Ayak ve Göz Bozuklukları
Disabilities of Hands, Feet and Eyes in Leprosy Patients
Mulalla BİÇER GENÇBAYa, Ayla KÜLTÜRb, Şaduman AYDIN ÖZÜÇELİKc, Doğaç Niyazi ÖZÜÇELİKd
aFizik Tedavi ve Rehabilitasyon Kliniği, İstanbul Bakırköy Dr. Sadi Konuk Eğitim ve
Araştırma Hastanesi,
bDeri ve Zührevi Hastalıkları Kliniği, Bakırköy Lepra Deri ve Zührevi Hastalıkları Hastanesi,
cGöz Hastalıkları Kliniği, İstanbul Ataköy Dünyagöz Hastanesi,
dİstanbul Üniversitesi-Cerrahpaşa Cerrahpaşa Sağlık Bilimleri Fakültesi, İstanbul, TÜRKİYE
Turkiye Klinikleri J Med Sci. 2019;39(1):83-8
doi: 10.5336/medsci.2019-64861
Article Language: TR
ÖZET
Amaç: Lepra, Mycobacterium leprae'nın neden olduğu, deri ve sinirleri tutan kronik, granulomatöz, latent bir hastalıktır. Bu çalışmanın amacı, lepra hastalarındaki yaşam kalitesini bozan el, ayak ve gözlerdeki bozuklukların derecelerini değerlendirmektir. Gereç ve Yöntemler: Bu çalışma, 2010-2013 yılları arasında Bakırköy Lepra Deri ve Zührevi Hastalıklar Hastanesi'nde takip ve tedavisi yapılan ve kayıt bilgilerine ulaşılan 87 lepra hastası ile yapılmıştır. Lepra hastalarının demografik özellikleri ile lepra nedenli "El-Ayak-Göz Bozulma Dereceleri" Dünya Sağlık Örgütü'nün önerdiği sınıflandırmalara göre değerlendirilmiştir. Herhangi bir bozulma yokluğundan ampütasyona kadar giden el ve ayak için bozulma dereceleri 0, 1 ve 2 üzerinden değerlendirilmiştir. Herhangi bir bozulma yokluğundan körlüğe kadar giden göz için bozulma dereceleri ise 0, 1, 2, 3 üzerinden değerlendirilmiştir. Bulgular: Araştırmaya alınan 87 lepra hastasının %69'u erkek, %31'i kadındı ve yaş ortalamaları 64,930±14,508 yıl bulundu. Lepra hastalarının %37,93'sinde üst ve alt ekstremitelerin farklı lokalizasyonlarda deformiteler (2. derece bozulma), %29,88?inde ampütasyonlar saptandı. Hastaların %65,5'i yürümek için herhangi bir desteğe ihtiyaç duymazken, %6,9'u protez, %4,35'i baston, %0,34'ü koltuk değneği ve %12,18'i tekerlekli sandalye kullanmak zorunda kalmışlardı. Hastaların %79,3'ünde her iki gözde de patoloji (sağ göz: %42,52'sinde 1.derece ve %34,48'inde 2. derece; sol göz: %41,37'sinde 1.derece ve %42,52'sinde 2. derece ve iki sağ gözde ve iki sol gözde lepra nedenli körlük olmak üzere 3. derece bozukluk) gelişmişti. Sonuç: Lepra hastalığının tedavi süreci, el, ayak ve gözlerde oluşturduğu bozulma ve deformiteler nedeniyle, erken tanısı ve rehabilitasyonunu da içerecek şekilde multidisipliner planlanmalı ve uygulanmalıdır.

Anahtar Kelimeler: Lepra; el; ayak; göz bozuklukları
ABSTRACT
Objective: Leprosy is a chronic, granulomatous, latent disease caused by Mycobacterium leprae, involving the skin and nerves. The aim of this study was to evaluate the degree of disability in the hand, foot, and eyes of patients with leprosy. Material and Methods: This study was carried out with 87 leprosy patients who were followed-up and treated in Bakırköy Lepra Skin and Venereal Diseases Hospital between 2010 and 2013 and their registration data were obtained. Demographic characteristics of leprosy patients and Leprosy' Hand-Foot-Eye-Disability Degrees in were evaluated according to the World Health Organization classifications. The degree of deteriotation for hand and foot from the absence of any deteriotation to amputation, was evaluated at 0, 1, 2. The degree of deteriotation for the eye, from the absence of any distortion to blindness, was evaluated over 0, 1, 2, 3. Results: Of the 87 lepra patients included in the study, 69% were male, 31% were female and the mean age was 64.930±14.508 years. In 37.93% of the leprosy patients, deformities (2nd degree deterioration) and amputations in 29.88% of the upper and lower extremities were detected. In 79.3% of patients, pathology developed in both eyes (right eye: 42.52% 1st degree and 34.48% 2nd degree disorder; left eye: 41.37% 1st degree and 42.52% 2nd degree disorder and 2 right eyes and 2 left eyes; 4-blindness-3rd degree disorder caused by leprosy). Conclusion: The treatment process of leprosy patients should be planned to be multidisciplinary, including early diagnosis and rehabilitation, due to the deformities of the disease in the hands, feet and eyes.

Keywords: Leprosy; disability; hands; feet; eyes
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