<\/span><\/h2>\nBir di\u015f apsesi genellikle di\u015fin i\u00e7 tabakas\u0131 (pulpa)<\/b> enfekte oldu\u011funda geli\u015fir. Pulpa, di\u015fin kalbidir \u2014 sinirler, damarlar ve ba\u011f dokusundan olu\u015fur. \u00c7\u00fcr\u00fck, k\u0131r\u0131k, di\u015f eti \u00e7ekilmesi veya eski dolgu s\u0131z\u0131nt\u0131s\u0131 gibi durumlarda bakteriler buraya ula\u015f\u0131r. Ba\u011f\u0131\u015f\u0131kl\u0131k sistemi enfeksiyonu durdurmak i\u00e7in h\u00fccum eder, ancak bazen bu sava\u015f b\u00f6lgesinde irin birikir ve d\u0131\u015far\u0131 \u00e7\u0131kamay\u0131nca apse olu\u015fur.<\/p>\n
Apse olu\u015fumunun en yayg\u0131n nedenleri \u015funlard\u0131r:<\/b><\/p>\n\n- Tedavi edilmeyen derin di\u015f \u00e7\u00fcr\u00fckleri<\/b><\/li>\n
- Di\u015f eti hastal\u0131klar\u0131<\/b> (gingivitis ve periodontitis)<\/li>\n
- K\u0131r\u0131k veya \u00e7atlam\u0131\u015f di\u015fler<\/b> (\u00f6zellikle travma sonras\u0131)<\/li>\n
- Ba\u015far\u0131s\u0131z kanal tedavileri<\/b> veya s\u0131z\u0131nt\u0131 yapan dolgular<\/li>\n
- G\u00f6m\u00fck 20 ya\u015f di\u015fleri<\/b> etraf\u0131nda biriken bakteriler<\/li>\n
- Ba\u011f\u0131\u015f\u0131kl\u0131k sisteminin zay\u0131flamas\u0131, stres veya diyabet<\/li>\n<\/ul>\n
E\u011fer bu enfeksiyon zaman\u0131nda tedavi edilmezse, bakteriler kemik dokusuna<\/b> hatta kana<\/b> kadar ula\u015fabilir.<\/p>\n<\/span>Di\u015f Apsesi T\u00fcrleri<\/b><\/span><\/h2>\n<\/span>1. Periapikal Apse (Di\u015f K\u00f6k\u00fc Ucu Apsesi)<\/b><\/span><\/h3>\nBu apse, di\u015fin k\u00f6k ucunda olu\u015fur. Bakteriler di\u015fin i\u00e7indeki sinir dokusuna kadar ilerler ve k\u00f6k ucundaki kemik dokusunda enfeksiyona neden olur.<\/p>\n
Belirtileri:<\/b><\/p>\n\n- Zonklay\u0131c\u0131, nab\u0131z gibi atan di\u015f a\u011fr\u0131s\u0131<\/li>\n
- S\u0131cak-so\u011fuk hassasiyeti<\/li>\n
- \u00c7i\u011fneme s\u0131ras\u0131nda bask\u0131 hissi<\/li>\n
- \u0130lerlemi\u015f vakalarda y\u00fczde \u015fi\u015flik<\/li>\n<\/ul>\n
Tedavi:<\/b> Genellikle kanal tedavisi (endodontik tedavi)<\/b> uygulan\u0131r. \u0130leri durumlarda apse bo\u015falt\u0131larak enfekte doku temizlenir.<\/p>\n<\/span>2. Periodontal Apse (Di\u015f Eti Apsesi)<\/b><\/span><\/h3>\nDi\u015f etleri ile di\u015f k\u00f6k\u00fc aras\u0131ndaki ceplerde iltihap birikmesiyle olu\u015fur. Di\u015f eti hastal\u0131klar\u0131 ilerledik\u00e7e di\u015f \u00e7evresinde bo\u015fluklar olu\u015fur, bu bo\u015fluklar bakteriler i\u00e7in m\u00fckemmel bir ortamd\u0131r.<\/p>\n
Belirtileri:<\/b><\/p>\n\n- \u015ei\u015f, k\u0131zar\u0131k ve dokununca a\u011fr\u0131yan di\u015f eti<\/li>\n
- Di\u015fin gev\u015femesi veya sallanmas\u0131<\/li>\n
- A\u011f\u0131z kokusu<\/li>\n
- Di\u015f etinden irin gelmesi<\/li>\n<\/ul>\n
Tedavi:<\/b> Di\u015f eti cepleri derinlemesine temizlenir, apse drene edilir ve gerekirse antibiyotik uygulan\u0131r. Periodontal tedavi sonras\u0131nda d\u00fczenli bak\u0131m \u00e7ok \u00f6nemlidir.<\/p>\n<\/span>3. Perikoronal Apse (G\u00f6m\u00fck Di\u015f Apsesi)<\/b><\/span><\/h3>\n\u00d6zellikle 20 ya\u015f di\u015fleri<\/b> etraf\u0131nda g\u00f6r\u00fcl\u00fcr. Di\u015f eti k\u0131smen a\u00e7\u0131lm\u0131\u015fsa, araya yemek art\u0131klar\u0131 ve bakteriler girer; bu da enfeksiyona yol a\u00e7ar.<\/p>\n
Belirtileri:<\/b><\/p>\n\n- \u00c7ene a\u011fr\u0131s\u0131 ve a\u011f\u0131z a\u00e7mada zorluk<\/li>\n
- Bo\u011faza yay\u0131lan a\u011fr\u0131<\/li>\n
- \u015ei\u015flik ve yutkunma g\u00fc\u00e7l\u00fc\u011f\u00fc<\/li>\n
- Ate\u015f ve halsizlik<\/li>\n<\/ul>\n
Tedavi:<\/b> Di\u015f etinin alt\u0131ndaki iltihap bo\u015falt\u0131l\u0131r, b\u00f6lge sterilize edilir. G\u00f6m\u00fck di\u015f sorun yarat\u0131yorsa, \u00e7ekim planlan\u0131r.<\/p>\n<\/span>Di\u015f Apsesi Belirtileri: V\u00fccudun Sinyallerini Okumak<\/b><\/span><\/h2>\nBir di\u015f apsesi genellikle \u201ck\u00fc\u00e7\u00fck bir a\u011fr\u0131yla\u201d ba\u015flar ama h\u0131zla \u015fiddetlenir. V\u00fccut bu durumu, farkl\u0131 \u015fekillerde uyararak g\u00f6sterir:<\/p>\n
\n- S\u00fcrekli, zonklay\u0131c\u0131 di\u015f a\u011fr\u0131s\u0131<\/li>\n
- Y\u00fczde, \u00e7enede veya boyunda \u015fi\u015flik<\/li>\n
- Ate\u015f, titreme, halsizlik<\/li>\n
- K\u00f6t\u00fc a\u011f\u0131z kokusu veya k\u00f6t\u00fc tat hissi<\/li>\n
- A\u011f\u0131z a\u00e7mada zorluk<\/li>\n
- Yutkunmada rahats\u0131zl\u0131k<\/li>\n
- Di\u015f etinden irin s\u0131zmas\u0131<\/li>\n
- Y\u00fczde asimetri (\u015fi\u015flik nedeniyle)<\/li>\n<\/ul>\n
Bu belirtiler, ba\u011f\u0131\u015f\u0131kl\u0131k sisteminizin enfeksiyonla sava\u015ft\u0131\u011f\u0131n\u0131 g\u00f6sterir. Ancak sava\u015f uzad\u0131k\u00e7a bakteriler v\u00fccudun di\u011fer b\u00f6lgelerine yay\u0131labilir. Bu durumda acil di\u015f hekimi m\u00fcdahalesi<\/b> gerekir.<\/p>\n<\/span>Di\u015f Apsesi Nas\u0131l Te\u015fhis Edilir?<\/b><\/span><\/h2>\n\u00d6mer Istanbul Dental Center gibi dijital donan\u0131ml\u0131 kliniklerde di\u015f apsesi tan\u0131s\u0131, birka\u00e7 a\u015famada konur:<\/p>\n
\n- Klinik Muayene:<\/b> Di\u015f hekimi, enfekte b\u00f6lgeyi g\u00f6zlemler ve dokunma hassasiyetini de\u011ferlendirir.<\/li>\n
- Radyografi (Panoramik R\u00f6ntgen):<\/b> Enfeksiyonun derinli\u011fi ve k\u00f6k ucundaki lezyonlar net \u015fekilde g\u00f6r\u00fcl\u00fcr.<\/li>\n
- 3D Tomografi (CBCT – Papaya 3D):<\/b> Enfeksiyonun kemik dokusuna yay\u0131l\u0131m\u0131 ve sinirlerle ili\u015fkisi milimetrik olarak \u00f6l\u00e7\u00fcl\u00fcr.<\/li>\n
- Vitalite Testi:<\/b> Di\u015fin sinirinin canl\u0131 olup olmad\u0131\u011f\u0131 kontrol edilir.<\/li>\n<\/ol>\n
Bu sayede apseye neden olan k\u00f6k, kanal veya di\u015f eti problemi tam olarak belirlenir ve gereksiz \u00e7ekimlerin \u00f6n\u00fcne ge\u00e7ilir.<\/p>\n
<\/span>Di\u015f Apsesi Tedavisi<\/b><\/span><\/h2>\n<\/span>1. Kanal Tedavisi (Endodontik Uygulama)<\/b><\/span><\/h3>\nApse di\u015fin k\u00f6k\u00fcnden kaynaklan\u0131yorsa en etkili \u00e7\u00f6z\u00fcm kanal tedavisidir. Di\u015fin i\u00e7indeki enfekte sinir dokusu \u00e7\u0131kar\u0131l\u0131r, k\u00f6k kanallar\u0131 sterilize edilir ve \u00f6zel dolgu materyaliyle kapat\u0131l\u0131r. Modern endodontik cihazlar (\u00f6rne\u011fin VDW Reciproc, Apex Locator) sayesinde i\u015flem a\u011fr\u0131s\u0131z ve tek seansta tamamlanabilir.<\/p>\n
<\/span>2. Antibiyotik Tedavisi<\/b><\/span><\/h3>\nApse dokulara yay\u0131lm\u0131\u015fsa antibiyotik deste\u011fi gerekir. Ancak antibiyotik sadece \u201cenfeksiyonun yay\u0131l\u0131m\u0131n\u0131 yava\u015flat\u0131r\u201d; apsenin tamamen yok olmas\u0131 i\u00e7in mekanik m\u00fcdahale (drenaj veya kanal tedavisi)<\/b> \u015fartt\u0131r.<\/p>\n<\/span>3. Drenaj (Apse Bo\u015faltma)<\/b><\/span><\/h3>\nB\u00fcy\u00fck veya derin apselerde di\u015f hekimi lokal anestezi alt\u0131nda k\u00fc\u00e7\u00fck bir kesi yaparak iltihab\u0131 bo\u015falt\u0131r. Bu i\u015flem an\u0131nda rahatlama sa\u011flar; ard\u0131ndan antibiyotik ve antiseptik tedaviyle enfeksiyon tamamen temizlenir.<\/p>\n
<\/span>4. Di\u015f \u00c7ekimi (Son \u00c7are)<\/b><\/span><\/h3>\nE\u011fer di\u015f k\u00f6k\u00fc ciddi hasar g\u00f6rm\u00fc\u015fse veya tedaviye yan\u0131t vermiyorsa, \u00e7ekim \u00f6nerilebilir. Bu durumda enfeksiyon temizlendikten sonra implant<\/b> veya k\u00f6pr\u00fc protezleri<\/b> planlan\u0131r.<\/p>\n<\/span>Tedavi Sonras\u0131 Bak\u0131m ve \u0130yile\u015fme S\u00fcreci<\/b><\/span><\/h2>\nTedavi sonras\u0131 d\u00f6nemde dikkat edilmesi gerekenler:<\/p>\n
\n- 24 saat boyunca s\u0131cak yiyecek\/i\u00e7ecek t\u00fcketmeyin.<\/li>\n
- Antibiyotik ve a\u011fr\u0131 kesicileri hekimin \u00f6nerdi\u011fi \u015fekilde kullan\u0131n.<\/li>\n
- \u015ei\u015flik varsa ilk 12 saatte so\u011fuk kompres, sonras\u0131nda \u0131l\u0131k tuzlu su gargaras\u0131 uygulay\u0131n.<\/li>\n
- Enfekte b\u00f6lgeyi f\u0131r\u00e7alamaktan ka\u00e7\u0131n\u0131n ama di\u011fer di\u015flerinizi temiz tutun.<\/li>\n
- Kontrol randevular\u0131n\u0131 aksatmay\u0131n; di\u015fin k\u00f6k iyile\u015fmesi radyografik olarak takip edilmelidir.<\/li>\n<\/ul>\n
<\/span>S\u0131k\u00e7a Sorulan Sorular<\/b><\/span><\/h2>\n<\/span>Di\u015f apsesi kendili\u011finden ge\u00e7er mi?<\/b><\/span><\/h3>\nHay\u0131r, di\u015f apsesi kendili\u011finden ge\u00e7mez<\/b> \u2014 sadece ge\u00e7ici olarak sakinle\u015febilir<\/b>. Bunun nedeni, apsenin bir \u201ckaps\u00fcl\u201d i\u00e7inde hapsolmu\u015f irin ve bakterilerden olu\u015fmas\u0131d\u0131r. Bazen apsedeki bas\u0131n\u00e7 azal\u0131r, a\u011fr\u0131 birka\u00e7 g\u00fcnl\u00fc\u011f\u00fcne hafifler ve hasta \u201ciyile\u015fti\u011fini\u201d zanneder. Fakat bu yaln\u0131zca enfeksiyonun derin dokulara veya kemik i\u00e7ine ilerledi\u011fi<\/b> anlam\u0131na gelir. V\u00fccut apsenin i\u00e7indeki bakterileri tamamen yok edemez, \u00e7\u00fcnk\u00fc bu kaps\u00fcl\u00fcn i\u00e7ine ba\u011f\u0131\u015f\u0131kl\u0131k h\u00fccreleri ve antibiyotikler yeterince n\u00fcfuz edemez.<\/b> Sonu\u00e7ta enfeksiyon kronik hale gelir, k\u00f6k ucundaki kemik dokusu erimeye ba\u015flar ve di\u015f zamanla gev\u015fer.<\/p>\n<\/span>Apseyi evde s\u0131kmak veya patlatmak neden tehlikelidir?<\/b><\/span><\/h3>\nEvde apse patlatmak, enfeksiyonu y\u00fczeyden uzakla\u015ft\u0131rmak yerine v\u00fccudun i\u00e7ine yayabilir.<\/b> Apsenin i\u00e7i milyonlarca bakteriyle doludur. Bu bakteriler irinle birlikte d\u0131\u015far\u0131 \u00e7\u0131kar gibi g\u00f6r\u00fcnse de, asl\u0131nda \u00e7o\u011fu \u00e7evre dokulara<\/b> ve hatta kan dola\u015f\u0131m\u0131na<\/b> kar\u0131\u015f\u0131r.<\/p>\n
Bu durumun do\u011furabilece\u011fi ciddi komplikasyonlar:<\/p>\n
\n- Sel\u00fclit:<\/b> Enfeksiyon cilt alt\u0131 dokular\u0131na yay\u0131l\u0131r, y\u00fcz veya boyun h\u0131zla \u015fi\u015fer.<\/li>\n
- Osteomyelit:<\/b> Bakteriler \u00e7ene kemi\u011fine ilerler, kemi\u011fi iltihapland\u0131r\u0131r.<\/li>\n
- Sepsis:<\/b> Enfeksiyon kana kar\u0131\u015f\u0131r; ate\u015f, tansiyon d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc ve organ yetmezli\u011fi gibi hayati belirtiler geli\u015fir.<\/li>\n
- Kalp kapak enfeksiyonu (Endokardit):<\/b> \u00d6zellikle kalp hastal\u0131\u011f\u0131 olan bireylerde risklidir.<\/li>\n<\/ul>\n
Ayr\u0131ca apsenin kendi kendine bo\u015falmas\u0131, \u00e7o\u011fu zaman enfeksiyonun yaln\u0131zca y\u00fczey k\u0131sm\u0131n\u0131<\/b> temizler; altta kalan odak b\u00fcy\u00fcmeye devam eder.<\/p>\n<\/span>Di\u015f apsesi tedavi edilmezse ne olur?<\/b><\/span><\/h3>\nTedavi edilmeyen di\u015f apsesi zamanla sadece di\u015fi de\u011fil, \u00e7evresindeki kemik ve yumu\u015fak dokular\u0131<\/b> da etkiler. A\u015fa\u011f\u0131daki komplikasyonlar geli\u015febilir:<\/p>\n
K\u00f6k Ucu Kemi\u011finde Erozyon:<\/b> Enfeksiyon k\u00f6k ucundan kemi\u011fe s\u0131zar; bu b\u00f6lgede kemik \u00e7\u00f6z\u00fcl\u00fcr ve di\u015f destek dokusunu kaybeder.<\/p>\n
Sin\u00fcs Enfeksiyonu:<\/b> \u00dcst \u00e7enedeki apseler sin\u00fcs bo\u015flu\u011funa ilerleyebilir. Bu durum kronik sin\u00fczit<\/b> benzeri burun t\u0131kan\u0131kl\u0131\u011f\u0131 ve ba\u015f a\u011fr\u0131s\u0131na yol a\u00e7ar.<\/p>\n
Lenf Bezi \u015ei\u015fli\u011fi:<\/b> Boyundaki lenf bezleri enfeksiyona tepki olarak b\u00fcy\u00fcr, dokunmakla a\u011fr\u0131l\u0131 hale gelir.<\/p>\n
Y\u00fcz Asimetrisi ve \u015ei\u015flik:<\/b> Apse ilerledik\u00e7e y\u00fcz\u00fcn bir taraf\u0131 \u015fi\u015febilir. Bu durum estetik a\u00e7\u0131dan rahats\u0131z edici oldu\u011fu gibi, \u00e7ene hareketini de k\u0131s\u0131tlar.<\/p>\n
Sepsis (Kan Zehirlenmesi):<\/b> Bakteriler kana kar\u0131\u015f\u0131rsa ate\u015f, halsizlik, h\u0131zl\u0131 nab\u0131z ve tansiyon d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc gibi belirtiler ortaya \u00e7\u0131kar. Bu, t\u0131bbi olarak hayati tehlike<\/b> anlam\u0131na gelir.<\/p>\n
Kalp veya B\u00f6brek Komplikasyonlar\u0131:<\/b> A\u011f\u0131z enfeksiyonlar\u0131 sistemik dola\u015f\u0131ma kar\u0131\u015ft\u0131\u011f\u0131nda, kalp kapaklar\u0131 ve b\u00f6brek dokusu zarar g\u00f6rebilir.<\/p>\n<\/span>Di\u015f apsesi tekrarlar m\u0131?<\/b><\/span><\/h3>\nEvet, tekrar edebilir. Di\u015f apsesinin n\u00fcks etmesinin birka\u00e7 ana nedeni vard\u0131r:<\/p>\n
\n- Eksik kanal tedavisi:<\/b> Kanal tam temizlenmemi\u015fse bakteriler yeniden aktifle\u015fir.<\/li>\n
- Di\u015f eti hastal\u0131klar\u0131:<\/b> Periodontal cepler bakterilerin yeniden birikmesine neden olur.<\/li>\n
- K\u00f6k \u00e7atlaklar\u0131:<\/b> Mikroskobik \u00e7atlaklardan bakteriler di\u015f i\u00e7ine s\u0131zabilir.<\/li>\n
- Ba\u011f\u0131\u015f\u0131kl\u0131k zay\u0131fl\u0131\u011f\u0131:<\/b> Stres, yorgunluk, kronik hastal\u0131klar (\u00f6rne\u011fin diyabet) enfeksiyon riskini art\u0131r\u0131r.<\/li>\n
- Kronik sin\u00fczit:<\/b> \u00dcst \u00e7ene di\u015flerindeki apseler, sin\u00fcsle ba\u011flant\u0131l\u0131ysa s\u00fcrekli enfeksiyon d\u00f6ng\u00fcs\u00fc yaratabilir.<\/li>\n<\/ul>\n
Tekrarlayan apseler genellikle derin bir odak enfeksiyonunun<\/b> belirtisidir. Baz\u0131 durumlarda, r\u00f6ntgende g\u00f6r\u00fclmeyen mikroskobik k\u00f6k kanallar\u0131 veya yandaki di\u015fin enfeksiyonu da apseyi tekrar ba\u015flatabilir.<\/p>\n<\/span>Di\u015f apsesi a\u011fr\u0131s\u0131 nas\u0131l hafifletilir? (Ge\u00e7ici \u00c7\u00f6z\u00fcmler)<\/b><\/span><\/h3>\nEvde uygulayabilece\u011finiz baz\u0131 ge\u00e7ici rahatlatma y\u00f6ntemleri<\/b> vard\u0131r, ancak bunlar tedavi yerine ge\u00e7mez:<\/p>\n
So\u011fuk Kompres:<\/b> Y\u00fczdeki \u015fi\u015fli\u011fi azaltmak i\u00e7in 15\u2019er dakikal\u0131k aral\u0131klarla buz torbas\u0131 uygulay\u0131n.<\/p>\n
Il\u0131k Tuzlu Su Gargaras\u0131:<\/b> Tuzlu su, a\u011f\u0131z i\u00e7indeki bakteriyel y\u00fck\u00fc azalt\u0131r. G\u00fcnde 2-3 kez yap\u0131labilir.<\/p>\n
Ba\u015f Y\u00fcksek Uyuma:<\/b> Ba\u015f\u0131n y\u00fcksekte olmas\u0131 apsedeki bas\u0131nc\u0131 azaltarak a\u011fr\u0131y\u0131 hafifletir.<\/p>\n
A\u011fr\u0131 Kesici Kullan\u0131m\u0131:<\/b> \u0130buprofen veya parasetamol, di\u015f hekimi tavsiyesiyle kullan\u0131labilir. Aspirin, \u00f6zellikle kan suland\u0131r\u0131c\u0131 etkisi nedeniyle \u00f6nerilmez.<\/p>\n
Ancak bunlar sadece ge\u00e7ici \u00e7\u00f6z\u00fcmlerdir.<\/b> A\u011fr\u0131 azal\u0131r ama enfeksiyon ortadan kalkmaz. Kanal tedavisi veya drenaj yap\u0131lmadan apse tamamen iyile\u015fmez.<\/p>\n","protected":false},"excerpt":{"rendered":"
V\u00fccuda giren bakteri ve vir\u00fcsler v\u00fccuttaki ba\u011f\u0131\u015f\u0131kl\u0131k sistemi elemanlar\u0131n\u0131n savunmas\u0131 ile kar\u015f\u0131la\u015f\u0131r. Akyuvar ve di\u011fer savunma h\u00fccreleri v\u00fccuda giren zararl\u0131 organizmalar\u0131 v\u00fccudun d\u0131\u015f\u0131na atmak ve hastalar\u0131 engellemek i\u00e7in b\u00fcy\u00fck bir diren\u00e7 g\u00f6sterirler. B\u00f6ylelikle bir\u00e7ok rahats\u0131zl\u0131k olu\u015fturacak mikrobiyal unsuru hastalanmadan atlat\u0131r\u0131z. Apse denen \u015fey de bu savunma ve sald\u0131r\u0131lar sonucunda v\u00fccutta meydana gelen irin birikimidir. Sava\u015f\u0131n…<\/p>\n","protected":false},"author":4,"featured_media":16047,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2738","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-dis-sagligi"],"yoast_head":"\n
Di\u015f Apsesi Nedir? Belirtileri, Nedenleri ve Tedavi Y\u00f6ntemleri<\/title>\n<meta name=\"description\" content=\"Di\u015f apsesi belirtileri, nedenleri ve tedavi y\u00f6ntemleri. Kanal tedavisi, drenaj ve antibiyotik s\u00fcre\u00e7leri hakk\u0131nda uzman di\u015f hekimlerinden bilgi al\u0131n.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Di\u015f Apsesi Nedir? Belirtileri, Nedenleri ve Tedavi Y\u00f6ntemleri\" \/>\n<meta property=\"og:description\" content=\"Di\u015f apsesi belirtileri, nedenleri ve tedavi y\u00f6ntemleri. 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