Alt Ekstremite Derin ven Trombozunda Medikal Tedavi: Retrospektif Çalışma

Yıl 2017, Cilt: 9 Sayı: 4, 270 - 282, 01.12.2017

İlker Kaya Mehmet Çeber Cemal Aslan İlker Akar

Öz

Amaç: Derin ven trombozu (DVT) zamanında teşhis edilip tedavi edilmediği zaman
ciddi morbidite ve mortalite ile sonuçlanabilen bir hastalıktır. İlimiz devlet
hastanesi kalp ve damar cerrahisi polikliniğine başvuran alt ekstremite DVT
nedeniyle tedavi edilen hastalar retrospektif olarak incelendi.

Gereç ve Yöntem: Kliniğimize Ocak 2010 - Aralık 2016 tarihleri arasında alt
ekstremitelerinde ağrı ve şişlik şikayetleri ile başvuran 424 hastaya Wells
skorlaması uygulandı. Wells skoru 2' nin üzerinde olan hastalara alt ekstremite
renkli venöz doppler ultrasonografi çekildi. DVT tanısı alanlar yatırıldı.

Bulgular: Tüm hastaların Wells skoru 2'nin üzerindeydi ve çekilen doppler
ultrasonografi sonucunda 323 (%76,1) hastada DVT tespit edildi. Tromboz
saptanan olguların 165’i kadın (%51), 158’i erkek (%48,9) olup ortalama yaş 57
idi. DVT oluşumunda 77 (%23.8) hastada belirli bir risk faktörü bulunamazken,
belirlenen risk faktörlerinden en sık olarak 56’sında (%17,3) obstetrik
nedenler ve 56’sında (%17,3) immobilizasyon tespit edilmiştir. Olguların 157’
sine (%48,6) standart heparin infüzyonu, 154’üne (%47,6) ise günde 2 kez düşük
molekül ağırlıklı heparin uygulandı. Massiv iliyak trombozlu 12 (%3,7) hastaya
ise trombolitik tedavi verildi. Hastaların 8’inde (%2.4) pulmoner emboli
gelişti. Bu hastalardan 4’ü massif pulmoner emboli nedeniyle kaybedildi (%1.2).

Sonuç: Komplikasyonlarının önlenmesi açısından klinik olarak DVT düşünülen
hastalarda doppler ultrasonografi ile tanı kesinleştirilmeli ve erken dönemde
uygun tedavi başlanmalıdır.

Anahtar Kelimeler

Derin ven trombozu, Doppler Ultrasonografi, Heparin

Medical Treatment of Lower Extremity Deep Vein Thrombosis: Retrospective Study

Öz

Objective: Deep vein thrombosis (DVT) is an
important cause of morbidity and mortality world wide unless treated on time.
This retrospective study aimed to share our experience with our collegues
regarding lower extremity DVT treatments in our hospital.

Materials
and Methods:
Between January2010- December, 2016; 424 patients applied at our hospital as
suffering from pain and swallow. Clinical signs and symptoms of DVT were
classified according to the Wells scoreing. If wells scoreing is higher than 2,
 patients were examined with lower
extremity venous doppler ultrasonography. The ones at whom  thrombosis were detected, were hospitalized.

Results: It was found that Wells score of
all patients was above 2 and DVT was observed in 323 patients (76,1%). 165
patients (51%) were females and of the 158 patients (48,9%) were males, and
avarage age 57. There was no risk factors for DVT in the 77 (23,8%) patients. The
most common risk factors for DVT were obstetric causes in 56 patients; (17,3%)
and immobilization in 56 patients (17,3%). Standart heparin infusion was
administered to 157 patients (48,6%) while the remaining patients 154 (47,6%)
had low molecular weight heparin twice a day. 12 patients (3.7%) with massive
iliac thrombosis were treated with thrombolytic therapy. Pulmonary embolus was
developed in the 8 patients (2.4%) and four of them died due to massive
pulmonary emboli (1.2%).

Conclusion: These data indicate that early
suitable treatment of DVT is necessary to prevent its complications after a
definitive detection of DVT with a doppler ultrasonography.

Anahtar Kelimeler

Deep vein thrombosis, Doppler Ultrasonography, Heparin

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