{"id":982,"date":"2012-08-12T12:23:03","date_gmt":"2012-08-12T09:23:03","guid":{"rendered":"http:\/\/www.hvtd.org\/?p=982"},"modified":"2012-08-12T12:23:03","modified_gmt":"2012-08-12T09:23:03","slug":"hava-yolu-ile-seyahatlerde-hastalik-ve-olumler","status":"publish","type":"post","link":"https:\/\/www.hvtd.org\/?p=982","title":{"rendered":"Hava yolu ile seyahatlerde hastal\u0131k ve \u00f6l\u00fcmler"},"content":{"rendered":"

\"\"<\/a>Hava yolu ile seyahatin giderek yayg\u0131nla\u015ft\u0131\u011f\u0131, y\u0131lda iki milyar kadar insan\u0131n yolculuk amac\u0131yla u\u00e7a\u011fa bindi\u011fi bir d\u00fcnyada ya\u015famaktay\u0131z. Artan yolcu say\u0131s\u0131 i\u00e7indeki ya\u015fl\u0131 ve hastal\u0131kl\u0131 insanlar\u0131n say\u0131s\u0131ndaki art\u0131\u015f ise ticari havayolu \u015firketlerini her zamankinden daha \u00e7ok t\u0131bbi \u00f6nlemler almaya zorlamaktad\u0131r. Yani, havaalanlar\u0131nda u\u00e7u\u015fla ilgili t\u0131bbi problemleri ve m\u00fcdahale usullerini bilen uzman doktorlar\u0131n g\u00f6revlendirilmesi, m\u00fcrettebat\u0131n da bu konularda e\u011fitimli olmas\u0131 gerekmektedir.<\/p>\n

U\u00e7u\u015f Stresleri, Fizyolojik Problemler ve Hastal\u0131klar<\/p>\n

Her u\u00e7u\u015f, u\u00e7a\u011fa binen yolcular i\u00e7in az ya da \u00e7ok bir stres yarat\u0131r. Havaalanlar\u0131ndaki u\u00e7u\u015f \u00f6ncesi prosed\u00fcrler, bagaj teslimi, ko\u015fturmalar, u\u00e7a\u011fa yerle\u015fme, gecikmeler, u\u00e7u\u015f kazas\u0131 endi\u015feleri, u\u00e7u\u015f s\u0131ras\u0131ndaki problemler, t\u00fcrb\u00fclans, ini\u015ften sonraki tela\u015flar vs., en k\u0131sa u\u00e7u\u015flarda bile yolculara stres y\u00fckler. Bu stres kalp ritim bozukluklar\u0131na, kan bas\u0131nc\u0131n\u0131n y\u00fckselmesine, p\u0131ht\u0131la\u015fma art\u0131\u015f\u0131 sonucu damar t\u0131kanmalar\u0131na neden olabilir. U\u00e7u\u015f m\u00fcrettebat\u0131nda ve yolcularda rastlanan en s\u0131k u\u00e7u\u015f i\u00e7i \u00f6l\u00fcm nedenlerinin kalp hastal\u0131klar\u0131 olu\u015fu bu durumla ilgilidir.<\/p>\n

U\u00e7u\u015f s\u0131ras\u0131nda kabin i\u00e7i bas\u0131nc\u0131; 5000-8000 feet (1500-2400 metre) irtifaya e\u015f de\u011ferdir. Bu irtifadaki d\u00fc\u015f\u00fck bas\u0131n\u00e7, solunum yolu enfeksiyonu olan ki\u015filerde kulak ve sin\u00fcs, \u00e7\u00fcr\u00fck di\u015fi olanlarda di\u015f, ve gazl\u0131 ki\u015filerde kar\u0131n a\u011fr\u0131lar\u0131na neden olabilir. (Gaz yapan g\u0131dalardan ka\u00e7\u0131nman\u0131n, gaz giderici ila\u00e7lar alman\u0131n, burun t\u0131kan\u0131kl\u0131\u011f\u0131 ve sin\u00fcziti olanlar\u0131n ise burun damlas\u0131 kullanmalar\u0131 bu t\u00fcr rahats\u0131zl\u0131klar\u0131 giderece\u011fi bilinmelidir.) Solunum havas\u0131ndaki oksijenin k\u0131smi bas\u0131nc\u0131n\u0131n azalmas\u0131 (hipoksi), sa\u011fl\u0131kl\u0131 ki\u015filer i\u00e7in problem yaratmayabilir ancak kalp ve akci\u011fer yetmezli\u011fi, anemi ve beyin dola\u015f\u0131m bozuklu\u011fu olan hastalarda bu d\u00fczeydeki bir hipoksi, rahats\u0131zl\u0131\u011fa veya hastal\u0131\u011f\u0131n alevlenmesine yol a\u00e7abilir. U\u00e7u\u015f s\u0131ras\u0131nda kabin i\u00e7i bas\u0131nc\u0131n\u0131n azalmas\u0131yla paralel olarak nem de azal\u0131r; ciltte ve g\u00f6z\u00fcn korneas\u0131nda kuruma meydana gelir; \u00f6zellikle kontakt lens kullananlarda bu \u00f6nemlidir.<\/p>\n

U\u00e7u\u015fta yolcular\u0131n g\u00f6sterdikleri sa\u011fl\u0131k sorunlar\u0131 s\u0131ralamas\u0131nda en \u00f6nde, ya\u015famsal olmayan rahats\u0131zl\u0131klar yer almaktad\u0131r : \u00e7e\u015fitli a\u011fr\u0131lar, solunum g\u00fc\u00e7l\u00fc\u011f\u00fc, bulant\u0131-kusma.<\/p>\n

Uzun s\u00fcre dar bir alanda hareketsiz oturmak y\u00fcz\u00fcnden baz\u0131 ki\u015filerde \u00f6dem ve kramp gibi hafif \u015fikayetlerden, akci\u011fer embolisi ve derin ven trombozu gibi tehlikeli rahats\u0131zl\u0131klara kadar problemler \u00e7\u0131kabilir. \u201cEkonomi s\u0131n\u0131f\u0131 sendromu\u201d \u015feklinde bilinen derin ven trombozu hastal\u0131\u011f\u0131 olan ki\u015filer, u\u00e7akta uzun s\u00fcre ayaklar\u0131 a\u015fa\u011f\u0131 pozisyonda oturduklar\u0131nda bacaklar\u0131nda kan g\u00f6llenmesi ve p\u0131ht\u0131 olu\u015fmas\u0131 riskine maruz kal\u0131rlar. Bu ki\u015filerin zaman zaman gezinmeleri, bacaklar\u0131n\u0131 bel hizas\u0131nda yere paralel uzatmalar\u0131 ve ila\u00e7lar\u0131n\u0131 kullanmalar\u0131 \u00f6nerilmektedir. Uzun, k\u0131talararas\u0131 yolculuklarda jet-lag bir dizi sa\u011fl\u0131k sorunu yarat\u0131r (uyku d\u00fczensizli\u011fi, haz\u0131ms\u0131zl\u0131k, i\u015ftahs\u0131zl\u0131k, ba\u015f a\u011fr\u0131s\u0131, sersemlik hissi, yorgunluk vs.).<\/p>\n

Havayoluyla seyahatlerde \u00f6zel \u00f6nlem gerektiren hastal\u0131klar; kalp yetmezli\u011fi, ritim bozukluklar\u0131, angina pectoris, derin ven trombozu, ast\u0131m, amfizem, stroke (inme), epilepsi (sara), diabet (\u015feker) ve enfeksiyon hastal\u0131klar\u0131d\u0131r. T\u00fcberk\u00fcloz gibi bula\u015f\u0131c\u0131 hastal\u0131klar ve beklenmedik davran\u0131\u015flar g\u00f6steren baz\u0131 ruh hastal\u0131klar\u0131na sahip ki\u015filer de belirli \u00f6nlemlerle u\u00e7urulmal\u0131d\u0131r.Durumu \u00e7ok \u00f6zel olan hastalar\u0131n bizzat doktorlar\u0131 nezaretinde veya onlar\u0131n haz\u0131rlayacaklar\u0131 bir rapor ile seyahat ettirilmeleri; solunum problemi olanlar i\u00e7in ta\u015f\u0131nabilir \u00f6zel oksijen t\u00fcplerinin \u015firket taraf\u0131ndan temini gerekir (ki\u015filerin kendi oksijen sistemleri u\u00e7a\u011fa kabul edilmez).<\/p>\n

Ticari havayollar\u0131 \u015firketleri u\u00e7akta acil m\u00fcdahale i\u00e7in ilk yard\u0131m \u00e7antalar\u0131 bulundurmak ve kabin personelini ilk yard\u0131m e\u011fitiminden ge\u00e7irmek zorundad\u0131r. FAA (Federal Aviation Administration) taraf\u0131ndan 1991 y\u0131l\u0131nda yap\u0131lan bir ara\u015ft\u0131rmada, u\u00e7u\u015f s\u0131ras\u0131ndaki acil t\u0131bbi problemlerin %85\u2032ine u\u00e7ak yolcular\u0131 aras\u0131nda bulunan bir doktorun yard\u0131mc\u0131 oldu\u011fu anla\u015f\u0131lm\u0131\u015ft\u0131r. Bu imkan\u0131n bulunmad\u0131\u011f\u0131 hallerde telsizle yer irtibat\u0131 kurularak yard\u0131m al\u0131nmakta veya hastan\u0131n durumuna g\u00f6re en yak\u0131n meydana acil ini\u015f yap\u0131lmaktad\u0131r. En do\u011fru tutum, ciddi t\u0131bbi rahats\u0131zl\u0131klar\u0131 olan ki\u015filerin u\u00e7u\u015f \u00f6ncesinde havac\u0131l\u0131k t\u0131bb\u0131na a\u015fina bir uzman hekim taraf\u0131ndan de\u011ferlendirilmeleridir.<\/p>\n

U\u00e7u\u015f S\u0131ras\u0131ndaki \u00d6l\u00fcmler<\/p>\n

\u00d6l\u00fcm, u\u00e7u\u015f s\u0131ras\u0131nda nadiren kar\u015f\u0131la\u015f\u0131lan bir durumdur. FAA\u2019\u0131n 1986-1988 aras\u0131ndaki iki y\u0131l\u0131 kapsayan bir ara\u015ft\u0131rmas\u0131na g\u00f6re, ABD sivil havayolu ta\u015f\u0131mac\u0131l\u0131\u011f\u0131nda acil t\u0131bbi m\u00fcdahalede bulunulan 2.322 ki\u015fiden 33\u2032\u00fc u\u00e7u\u015fta \u00f6lm\u00fc\u015ft\u00fcr. Bu \u00f6l\u00fcmlerin 16\u2019s\u0131 (%48) kalp hastal\u0131\u011f\u0131 nedeniyle olmu\u015ftur. IATA (International Air Transport Association)\u2019\u0131n 1977-1984 aras\u0131ndaki 7 y\u0131ll\u0131k periyoda ait ara\u015ft\u0131rmas\u0131nda, 577 u\u00e7u\u015f-i\u00e7i \u00f6l\u00fcm kaydedilmi\u015f; bunlar\u0131n 326\u2019s\u0131n\u0131n (%56) kardiak nedenli oldu\u011fu rapor edilmi\u015ftir. U\u00e7u\u015f s\u0131ras\u0131nda ger\u00e7ekle\u015fen \u00f6l\u00fcmlerin, ki\u015fide mevcut ciddi ve ya\u015famsal hastal\u0131\u011f\u0131n u\u00e7u\u015f stresiyle artmas\u0131 veya rastlant\u0131sal olarak u\u00e7u\u015f s\u0131ras\u0131nda ger\u00e7ekle\u015fmesi olas\u0131l\u0131klar\u0131 \u00fczerinde durulmaktad\u0131r. \u0130statistiksel de\u011ferlendirme sonu\u00e7lar\u0131na g\u00f6re, U\u00e7u\u015fta \u00f6l\u00fcm olas\u0131l\u0131\u011f\u0131 : 1 milyon yolcuda 0.31, veya 1 milyon u\u00e7u\u015fta 25.1 \u00f6l\u00fcm.<\/p>\n

Sonu\u00e7 olarak,<\/p>\n

1. Havayolu \u015firketlerinin \u00f6ncelikle u\u00e7a\u011fa binecek yolculardan sa\u011fl\u0131k sorunu olanlar\u0131 u\u00e7u\u015f \u00f6ncesinde t\u0131bbi y\u00f6nden de\u011ferlendirmeleri,<\/p>\n

2. Kabinde acil t\u0131bbi m\u00fcdahale imkanlar\u0131 ve e\u011fitilmi\u015f personel g\u00f6revlendirmeleri,<\/p>\n

3. \u00d6zel durumlarda yerden telsizle \u00f6nerileri al\u0131nacak uzman t\u0131bbi personel bulundurmalar\u0131, gerekti\u011fi anla\u015f\u0131lmaktad\u0131r.<\/p>\n

Kaynak : Aviat.Space Environ Med. 1996; 67-10 Supplement<\/p>\n

(Not: Cumhuriyet Gazetesi, Bilim Teknik Ekinde 24.3.2001 tarihinde yay\u0131nlanm\u0131\u015ft\u0131r)<\/p>\n

Yaz\u0131y\u0131 haz\u0131rlayan :<\/strong> Do\u00e7. Dr. Muzaffer \u00c7eting\u00fc\u00e7<\/p>\n","protected":false},"excerpt":{"rendered":"

Hava yolu ile seyahatin giderek yayg\u0131nla\u015ft\u0131\u011f\u0131, y\u0131lda iki milyar kadar insan\u0131n yolculuk amac\u0131yla u\u00e7a\u011fa bindi\u011fi bir d\u00fcnyada ya\u015famaktay\u0131z. Artan yolcu say\u0131s\u0131 i\u00e7indeki ya\u015fl\u0131 ve hastal\u0131kl\u0131 insanlar\u0131n say\u0131s\u0131ndaki art\u0131\u015f ise ticari havayolu \u015firketlerini her zamankinden daha \u00e7ok t\u0131bbi \u00f6nlemler almaya zorlamaktad\u0131r. Yani, havaalanlar\u0131nda u\u00e7u\u015fla ilgili t\u0131bbi problemleri ve m\u00fcdahale usullerini bilen uzman doktorlar\u0131n g\u00f6revlendirilmesi, m\u00fcrettebat\u0131n da bu konularda e\u011fitimli olmas\u0131 gerekmektedir. […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[6],"tags":[],"class_list":["post-982","post","type-post","status-publish","format-standard","hentry","category-bulten"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/982","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=982"}],"version-history":[{"count":1,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/982\/revisions"}],"predecessor-version":[{"id":984,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/982\/revisions\/984"}],"wp:attachment":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=982"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=982"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=982"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}