Kanserin Tromboembolik Komplikasyonları ve Tedaviye Yönelik Yaklaşımlar

Yıl 2009, Cilt: 42 Sayı: 2, 86 - 91, 01.08.2009

Yeşim Yıldırım Özgür Özyılkan

Öz

Venous thromboembolism is a common cause of mortality and morbidity in cancer patients. Risk factors for venous throm-boembolism include immobilization, surgery, hormonal treatments, chemotherapy and vascular injury due to venous catheters. Furthermore, most of the cancer cells release procoagulant substances which activate coagulation system directly or indirectly. İn case of high risk situations for venous thromboembolism such as hospitalization, surgery prophylactic use of low molecular vveight heparin is effective and safety. Unlike the patients with multiple myeloma receiving thalidomide, prophylaxis for venous thromboembolism has not been accepted as a Standard for patients receiving chemotherapy. Favorable effects of anticoagulati-on on cancer mortality are stili under investigation.

Anahtar Kelimeler

Cancer, thromboembolism.

Thromboembolic Complications of Cancer and Management

Öz

Venöz tromboemboiizm kanser hastalarında mortaiite ve morbiditenin önemli bir nedenidir. İmmobiHzasyon, cerrahi girişimler, hormona! tedaviler, kemoterapi ve venöz kateter kullanımı ile meydana gelen vasküler hasarlar venöz tromboemboiizm için risk faktörleridir. Bunun yanı sıra birçok kanser hücresi koagüiasyon sistemini doğrudan ya da dolaylı olarak aktive etme özelliği olan prokoagüian maddeler salgılar. Kanser hastalarında uzun süreli yatış, cerrahi girişim gibi venöz tromboemboiizm oluşumu için yüksek riskli durumlarda düşük molekül ağırlıklı heparin He profilaksinin etkili ve güvenli olduğu gösterilmiştir. Venöz tromboemboiizm için rutin profilaksi uygulanması talidomid kullanan multipl miyelomalı hastalar dışında kanser tedavisi alan diğer hastalarda henüz standart değildir. Birçok çalışmada uzun dönem antikoagülasyonun kanser mortalitesi üzerine olumlu etkileri araştırılmaktadır.

Anahtar Kelimeler

Kanser, tromboemboiizm.

Kaynakça

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