Prof. Dr. Onur Yaprak, “Sar\u0131l\u0131k, safra pigmentinin yani bilirubinin kanda art\u0131\u015f\u0131na ba\u011fl\u0131 olarak g\u00f6z, cilt ve mukozalar\u0131n sar\u0131ya boyanmas\u0131n\u0131 ifade eder. Sar\u0131l\u0131k bir hastal\u0131k de\u011fil, bir rahats\u0131zl\u0131\u011f\u0131n belirtisidir ve bir\u00e7ok durumda ortaya \u00e7\u0131kabilir.” dedi.<\/p>\n
Medipol Mega \u00dcniversite Hastanesi Organ Nakli B\u00f6l\u00fcm\u00fc\u2019nden Prof. Dr. Onur Yaprak, cilt ve g\u00f6zde sararmayla kendini belli eden sar\u0131l\u0131\u011f\u0131n nedenleri, belirtileri, te\u015fhis ve tedavisi konusunda bilgi verdi. Genel kan\u0131n\u0131n aksine sar\u0131l\u0131\u011f\u0131n bir hastal\u0131k de\u011fil ba\u015fka bir hastal\u0131\u011f\u0131n belirtisi oldu\u011funu s\u00f6yleyen Prof. Dr. Onur Yaprak, “V\u00fccudun kandaki at\u0131k madde bilirubini do\u011fru i\u015fleyememesi durumunda cilt ve g\u00f6zdeki beyaz k\u0131s\u0131mlar sar\u0131ms\u0131 renge d\u00f6n\u00fc\u015f\u00fcr. Baz\u0131 sar\u0131l\u0131k tiplerinde ise idrar rengi \u00e7ay rengi gibi koyula\u015f\u0131r ve d\u0131\u015fk\u0131 rengi kahverenginden beyaza do\u011fru a\u00e7\u0131l\u0131r. Sar\u0131l\u0131k her ya\u015fta g\u00f6r\u00fclebilir. \u0130ltihaplanan karaci\u011fer veya t\u0131kanm\u0131\u015f bir safra kanal\u0131 sar\u0131l\u0131\u011f\u0131n nedeni olabilir.” ifadelerini kulland\u0131.<\/p>\n
Nedir, nas\u0131l te\u015fhis edilir?<\/p>\n
Sar\u0131l\u0131\u011f\u0131n te\u015fhisinin kan tahliliyle konuldu\u011funu anlatan Prof. Dr. Onur Yaprak, “Kan tahlilindeki bilirubin d\u00fczeyi normalde 0.3-1.2 mg\/dl civar\u0131ndad\u0131r. Bu de\u011fer 2.5-3.0 mg\/dl\u2019ye eri\u015firse sar\u0131l\u0131k geli\u015fmi\u015f demektir. Ya\u015flanm\u0131\u015f kan alyuvarlar\u0131n\u0131n par\u00e7alanmas\u0131 sonucu olu\u015fan bilirubin maddesinin indirekt ve direkt olarak iki farkl\u0131 tipi vard\u0131r. Her iki tipten birinin veya ikisinin birden art\u0131\u015f\u0131yla toplam bilirubin de\u011feri y\u00fckselir” de\u011ferlendirmesinde bulundu.<\/p>\n
Bilurubin neden y\u00fckselir?<\/p>\n
Prof. Dr. Yaprak, kandaki bilirubin art\u0131\u015f\u0131na yol a\u00e7an olaylar zincirini \u015f\u00f6yle \u00f6zetledi: “Alyuvarlar\u0131n par\u00e7alanmas\u0131yla olu\u015fan indirekt bilirubin kan yoluyla karaci\u011fere ta\u015f\u0131n\u0131r, baz\u0131 kimyasal olaylardan sonra direkt bilirubin ad\u0131n\u0131 al\u0131p karaci\u011fer h\u00fccrelerinden safran\u0131n i\u00e7ine bo\u015falt\u0131l\u0131r. Safra kanal\u0131 i\u00e7inden ba\u011f\u0131rsa\u011fa akar. Bilirubinin kanda artmas\u0131 da bu mekanizman\u0131n basamaklar\u0131ndan herhangi birinde olu\u015fan aksama neticesi geli\u015fir.”<\/p>\n
T\u00fcrleri nelerdir, nas\u0131l tedavi edilir?<\/p>\n
Sar\u0131l\u0131\u011f\u0131n nedensel fakt\u00f6rlere g\u00f6re hemolitik, hepatik ve obstr\u00fcktif olmak \u00fczere \u00fc\u00e7 kategoride s\u0131n\u0131fland\u0131r\u0131ld\u0131\u011f\u0131n\u0131 anlatan Prof. Dr. Onur Yaprak, tedavinin altta yatan hastal\u0131\u011f\u0131n t\u00fcr\u00fcne g\u00f6re de\u011fi\u015fti\u011fini bildirdi.<\/p>\n
Prof. Dr. Onur Yaprak sar\u0131l\u0131\u011f\u0131n t\u00fcrleri hakk\u0131nda ise \u015fu bilgileri payla\u015ft\u0131:<\/p>\n
“Hemolitik sar\u0131l\u0131k, kan\u0131n a\u015f\u0131r\u0131 y\u0131k\u0131m\u0131 ile ilgili sar\u0131l\u0131klar olan hemolitik anemiler ve yenido\u011fan bebeklerin fizyolojik sar\u0131l\u0131\u011f\u0131 bu gruptad\u0131r. Alyuvarlar\u0131n a\u015f\u0131r\u0131 par\u00e7alanmas\u0131 (kan\u0131n y\u0131k\u0131m\u0131) sonucu karaci\u011ferin kabul edip i\u015fleyebilece\u011finden daha fazla indirekt bilirubin ortaya \u00e7\u0131kmas\u0131 sonucu geli\u015fir. Hemolizle ba\u011flant\u0131l\u0131 olmamakla beraber Gilbert sendromu en s\u0131k g\u00f6r\u00fclen indirekt bilirubin art\u0131\u015f nedenidir. Bu ki\u015filerde indirekt bilirubinin karaci\u011fer taraf\u0131ndan al\u0131m\u0131nda ve direkt bilirubine \u00e7evrilmesinde sorun vard\u0131r. Karaci\u011fer tamamen normaldir ancak karaci\u011ferde do\u011fu\u015ftan gelen bir enzim eksikli\u011fi nedeniyle bilirubin artar. Toplumun y\u00fczde 3 ila 7\u2019sinde bu sorun g\u00f6r\u00fcl\u00fcr. Ama bir hastal\u0131k de\u011fildir. A\u00e7l\u0131k, yorgunluk, a\u015f\u0131r\u0131 egzersiz gibi durumlarda birka\u00e7 g\u00fcnde ge\u00e7en sar\u0131l\u0131k durumlar\u0131 ortaya \u00e7\u0131kar.<\/p>\n
Hepatik sar\u0131l\u0131k, karaci\u011fer kaynakl\u0131d\u0131r. Hepatit A, B, C gibi hepatitler, siroz, kanser gibi hastal\u0131klar sonucu olu\u015fan karaci\u011fer hasar\u0131 bu gruptad\u0131rlar.<\/p>\n
Obstr\u00fcktif sar\u0131l\u0131k, t\u0131kanma sar\u0131l\u0131\u011f\u0131 olarak da bilinir. safra kesesinde yada yolunda ta\u015f, t\u00fcm\u00f6r, kanser, pankreas ba\u015f\u0131nda veya oniki parmak ba\u011f\u0131rsa\u011f\u0131nda geli\u015fen t\u00fcm\u00f6r ve kanserler gibi safran\u0131n karaci\u011ferden ba\u011f\u0131rsa\u011fa akt\u0131\u011f\u0131 yolu t\u0131kayan her t\u00fcrl\u00fc hastal\u0131k bu gruba girer. G\u00f6r\u00fcld\u00fc\u011f\u00fc \u00fczere sar\u0131l\u0131k bir\u00e7ok hastal\u0131\u011f\u0131n nedeni de\u011fil bir sonucu olarak geli\u015fir. Bizler asl\u0131nda sar\u0131l\u0131\u011f\u0131 de\u011fil onun alt\u0131nda yatan hastal\u0131\u011f\u0131 tedavi ederiz.”<\/p>\n","protected":false},"excerpt":{"rendered":"
PROF. DR. ONUR YAPRAK, “SARILIK, SAFRA P\u0130GMENT\u0130N\u0130N YAN\u0130 B\u0130L\u0130RUB\u0130N\u0130N KANDA ARTI\u015eINA BA\u011eLI OLARAK G\u00d6Z, C\u0130LT VE MUKOZALARIN SARIYA BOYANMASINI \u0130FADE EDER. SARILIK B\u0130R HASTALIK DE\u011e\u0130L, B\u0130R RAHATSIZLI\u011eIN BEL\u0130RT\u0130S\u0130D\u0130R VE B\u0130R\u00c7OK DURUMDA ORTAYA \u00c7IKAB\u0130L\u0130R.” DED\u0130.<\/p>\n","protected":false},"author":1,"featured_media":253898,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[62800,49272,125,2039,21061,16126],"class_list":["post-253897","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","tag-sarilik","tag-belirtisidir","tag-bir","tag-degil","tag-hastaligin","tag-hastalik"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.tvturk.com\/wp-content\/uploads\/2020\/01\/sarilik-bir-hastalik-degil-hastaligin-belirtisidir_9b49b58.jpg?fit=1000%2C666","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/paKIfm-1437","_links":{"self":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/253897","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/comments?post=253897"}],"version-history":[{"count":0,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/253897\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media\/253898"}],"wp:attachment":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media?parent=253897"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/categories?post=253897"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/tags?post=253897"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}