Title Koristi laboratorijske dijagnostike u hitnoj ginekološkoj službi Title (english) Benefits of laboratory diagnostics in Urgent Gynecology Service Author Helena Mravičić Mentor Ratko Matijević (mentor)Committee member Berivoj Mišković (predsjednik povjerenstva)Committee member Ivančica Delaš (član povjerenstva)Committee member Ratko Matijević (član povjerenstva)Granter University of Zagreb Defense date and country 2017-07-14, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Najčešći razlozi dolaska u hitnu ginekološku službu mogu se podijeliti prema dijagnozama u četiri skupine. To su: prekomjerno povraćanje u trudnoći, vaginalno krvarenje izvan trudnoće i tijekom trudnoće, te nespecifični bolovi u abdomenu. Unatoč tome, ne postoje dobro definirani kriteriji laboratorijske dijagnostike za postavljanje ispravne dijagnoze. Cilj naše studije je utvrditi značaj laboratorijske dijagnostike i njezin utjecaj na daljnje dijagnostičko terapijske postupke u hitnoj ginekološkoj službi. Ova prospektivna studija provedena je na Klinici za ženske bolesti i porode Kliničke bolnice «Merkur» u Zagrebu u razdoblju od 15. prosinca 2016. do 20. ožujka 2017.godine. U ispitivanje su uključene 321 ispitanice kod kojih su analizirane provedene laboratorijske pretrage, njihova zastupljenost po dijagnozama kao i postotak patoloških nalaza laboratorijskih testova, te jesu li dobiveni rezultati laboratorijskih postupaka utjecali na daljnje postupke s bolesnicama. Laboratorijske pretrage su grupirane u pet skupina; hematološki parametri, koagulacijski parametri, biokemijski parametri (jetreni enzimi, elektroliti, metaboliti i supstrati), HCG i C reaktivni protein. Ustanovljeno je da se kod ispitanica s hiperemezom 11% pretraga nalazi izvan referentnih vrijednosti, dok je u skupini ispitanica s vaginalnim krvarenjem izvan trudnoće taj broj veći i iznosi 40%. U skupini s nespecifičnim bolovima u abdomenu postotak pretraga izvan referentnog intervala iznosi 27% i konačno u ispitivanoj skupini s vaginalnim krvarenjem u trudnoći ta vrijednost iznosi samo 9%. Također, u posljednjoj skupini koagulacijski parametri kod svih ispitanica su bili unutar referentnog intervala te se dovodi u pitanje svrsishodnost analize spomenutog parametra.
Zaključno, laboratorijska dijagnostika predstavlja samo jedan od segmenata postavljanja ispravne dijagnoze i liječenja. Kod ispitanica s hiperemezom ima smisla određivati hematološke parametre i elektrolite. U skupini ispitanica s vaginalnim krvarenjem izvan trudnoće potrebno je odrediti hematološke i koagulacijske parametre te HCG, dok su kod ispitanica s krvarenjem u trudnoći isključivo potrebni samo hematološki parametri. Kod ispitanica s nespecifičnim bolovima u abdomenu od laboratorijskih pretraga vrijednost su pokazali hematološki parametri, CRP i HCG.
Abstract (english) The most common reasons for gynecological emergencies can be divided into four groups according to the their diagnosis. They include: hyperemesis gravidarum, vaginal bleeding outside and during the pregnancy, and nonspecific abdominal pain. In spite of that fact, there are no well-defined criteria of laboratory diagnostics to make an accurate diagnosis. The aim of the study is to determine the importance of laboratory diagnostics and its influence on further diagnostic therapy procedures in urgent gynecology services. This prospective study was done from 15th December 2016 until 20th March 2017 at the Department of Gynecology and Obstetrics of KB «Merkur» in Zagreb. The study included 321 female patients who were tested. The laboratory tests, their presence according to diagnoses as well as the percentage of pathology reports of laboratory tests and if the results of laboratory tests affected further procedures with the patients were analyzed. The laboratory tests were divided into five groups: hematology parameters, coagulation parameters, biochemical parameters (liver enzymes, electrolytes, metabolites and substrate), HCG and C reactive protein. The study found that 11% of the tests were above reference intervals with the hyperemesis gravidarum patients, while in the group with abnormal vaginal bleeding patients that number was 40%. In the group with nonspecific abdominal pain, the percentage of the tests above reference intervals was 27%. Lastly, in the group with vaginal bleeding during the pregnancy, the rate was 9%. In addition, the coagulation parameters taken in the last group were within the reference interval which made the use of the last parameter questionable. In conclusion, laboratory diagnostics presents only one of the segments in making a correct diagnosis and treatment. It is reasonable to determine hematology parameters and electrolytes in the group with hyperemesis. Hematology and coagulation parameters should be determined in the group with abnormal vaginal bleeding outside pregnancy as well as HCG. The patients with bleeding in pregnancy only need hematology parameters. The tests in patients with nonspecific abdominal pain showed rates in hematology parameters, CRP and HCG.
Keywords
laboratorijske pretrage
hitna ginekološka služba
Keywords (english)
laboratory tests
urgent gynecology service
Language croatian URN:NBN urn:nbn:hr:105:206072 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2017-10-24 09:50:09
