BibTex RIS Kaynak Göster

Medical Treatment of Lower Extremity Deep Vein Thrombosis: Retrospective Study

Yıl 2008, Cilt: 13 Sayı: 1, 35 - 38, 01.02.2008

Öz

Objective: Deep vein thrombosis (DVT) is an important cause of morbidity and mortality worldwide 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 the years 2002-2006, 212 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 well scoreing higher than 2, then patients got on doppler ultrasonography and thrombosis diagnosed patients were hospitalized. Results: It was found that Wells score of all patients was above 2 and DVT was observed in 173 patients (81.6 %). 88 patients (50.9%) were females and of the 85 patients (49.1%) were males, and avarage age 48. It was also found that there was no risk factors for DVT in the 36 (20.8%) patients while diagnosed the most common risk factors for DVT were cause of obstetric (28 patients; 16.2%) and immobilization (28 patients; 16.2%). Standart heparin infusion was administered to 88 subjects (50.9%) while the remaining subjects (79) (45.7%) had a low molecular weight heparin twice a day. Six patients (3.4%) with massive iliac thrombosis got a thrombolytic therapy. Pulmonary embolus was developed in the 4 patients (2.3%) and two of them died due to massive pulmonary emboli (1.1%). Conclusion: These data indicate that it is necessary early suitable treatment of DVT to prevent its complications after a definitive detection of DVT with a doppler ultrasonography. ©2008, Firat University, Medical Faculty

Kaynakça

  • Oger E. Incidence of venous thromboembolism: a community- based study in Western France. EPI-GETBP Study Group. Groupe d'Etude de la Thrombose de Bretagne Occidentale. J Thromb Haemost 2000; 83: 657-660.
  • Brill-Edwards P, Lee A. D-Dimer testing in the diagnosis of acute venous thromboembolism. J Thromb Haemost 1999; 82: 688–694.
  • Bilkay Ö, Çağırıcı U, Engin Ç. Derin ven trombozu ve pulmoner tromboemboli. Duran E (editör). Kalp ve Damar Cerrahisi. 1. Baskı, İstanbul: Çapa Tıp Kitapevi, 2004: 863-878.
  • Heit JA, Silverstein MD, Mohr DN, et al. The epidemiology of venous thromboembolism in the community. J Thromb Haemost 2001; 86: 452-463.
  • Silverstein MD, Heit JA, Mohr DN ve ark. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998; 158: 585-593.
  • Heim SW, Schectman JM, Siadaty MS, Philbrick JT. D-dimer testing for deep venous thrombosis: a metaanalysis. Clin Chem 2004; 50: 1136-1147.
  • Hyers TM, Agnelli G, Hull RD, et al. Antithrombotic therapy for venous thromboembolic disease. Chest 2001;119:176–193.
  • LaPorte D, Farber S ,Sorin S, et al. When deep venous thrombosis fails to respond to therapy. J Am Board Fam Pract 2003;16:246- 250.
  • Blum A, Roche EA. Endovascular management of acute deep vein thrombosis. J Med. 2005; 118: 31-36.
  • Wells PS, Anderson DR, Rodger M ve ark. Evaluation of D-dimer in the diagnosis of suspected deep vein thrombosis. N Engl J Med 2003; 349: 1227-1235.
  • Wells PS, Anderson DR, Bormanis J, et al. Value ofassessment of pretest probability of deep-vein thrombosis inclinical management. Lancet 1997; 350: 1795– 1798.
  • Kassai B, Boissel JP, Cucherat M, et al. A systematic review of the accuracy of ultrasound in the diagnosis of deep venous thrombosis in asymptomatic patients. J Thromb Haemost 2004; 91: 655-666.
  • Kearon C, Ginsberg JS, Hirsh J. The role of venous ultrasonography in the diagnosis of suspected deep venous thrombosis and pulmonary embolism. Ann Intern Med 1998; 129: 1044-1049.
  • Kearon C, Julian JA, Newman TE, et al. Noninvasive diagnosis of deep vein thrombosis. Ann Intern Med 1998;128:663-677.
  • Tick LW, Ton E, van Voorthuizen T, et al. Practical diagnostic management of the patients with clinically suspected deep vein thrombosis ultrasonography, and D-dimer test. Am J Med 2002; 113: 630-635. probability test, compression
  • Beyer J, Schellong S. Deep vein thrombosis:Current diagnostic strategy. Eur J Inter Med. 2005: 238-246.
  • Ziegler S, Schillinger M, Maca TH, Minar E. Postthrombotic syndrome after primary event of deep venous thrombosis 10 to 20 years ago. Thromb Res. 2001; 101: 23–33.
  • Elliot MS, Immelman EJ, Jeffery P, et al. A comparative randomized trial of heparin versus streptokinase in the treatment of acute proximal venous thrombosis: an interim report of a prospective trial. Br J Surg.1979; 66: 838–843.
  • Arnesen H, Hiseth A, Ly B. Streptokinase or heparin in the treatment of deep vein thrombosis: follow-up results of a prospective study. Acta Med Scand. 1982; 211: 65– 68.
  • Merli G. Anticoagulants in the treatment of deep vein thrombosis. Am J Med. 2005; 118: 13-20.
  • Hull RD, Raskob GE, Brant RF, et al. Optimal therapeutic level of heparin therapy in patients with venous thromboembolism. Arch Intern Med 1992; 152: 1589-1595.
  • Rasche RA, Reilly BM, Guıdry JR, et al. The weight-based heparin dosing nomogram compared with a”Standard care” nomogram:a randomized controlled trial. Ann Intern Med 1993; 119: 874-881.
  • Leizorovicz A. Comparison of the efficacy and safety of low molecular weight heparins and unfractionated heparin in the initial treatment of deep venous thrombosis: an updated meta-analysis. Drugs 1996; 52: 30-37.
  • McRae SJ, Ginsberg JS. Initial treatment of venous
  • thromboemolism. Circulation 2004; 110: 3-9.
  • Lensing AWA, Prins MH, Davidson BL, Hirsh J. Treatment of deep venous thrombosis with low molecular weight heparins: a meta analysis. Arch Intern Med 1995; 155: 601-607.
  • Hull RD, Raskob GE, Pineo, et al. Subcutaneous low-molecular- weight heparin compared with continuous intravenous heparin in the treatment of proximal vein thrombosis. N Engl J Med 1992; 326: 975-982.
  • Weitz JI. Low molecular-weight heparins. N Engl J Med 1997; 337: 688-698.
  • Hirsh J, Warkentin TE, Shaughnessy SG, et al. Heparin and low molecular-weight heparin: mechanisms of action, pharmaco- kinetics, dosing, monitoring, efficacy, and safety. Chest 2001; 119: 64-94.
  • Comerota AJ, Chahwan S. Thrombolytic therapy for Acute Venous Thrombosis.In: Bergan JJ (Editor). The Vein Book. USA, Elsevier academic Pres, 2007: 455-464.
  • Comerota AJ, Gale SS. Operative venous thrombectomy. In: Bergan JJ (Editor). The Vein Book. USA, Elsevier academic Pres, 2007: 405-416.
  • Decousus H, Leizorovicz A, Parent F, et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prevention du Risque d'Embolie Pulmonaire par Interruption Cave Study Group. N Engl J Med. 1998; 338: 409-415.
  • Levine MN, Hirsh J, Gent M, et al. Optimal duration of oral anticoagulation therapy: a randomized trial comparing four weeks with three months of warfarin in patients with proximal deep vein thrombosis. J Thromb Haemost1995; 74: 606-611.
  • Kearon C, Ginsberg JS, Kovacs MJ, et al. Comparision of low- intensity warfarin therapy for long therm prevention of recurrent venous thromboembolism. N Eng J Med 2003; 349: 631-639.
  • Kabul Tarihi:28.06.2007

Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma

Yıl 2008, Cilt: 13 Sayı: 1, 35 - 38, 01.02.2008

Öz

Amaç: Derin ven trombozu (DVT) zamanında teşhis edilip tedavi edilmediğinde ciddi morbidite ve mortalite ile sonuçlanan bir hastalıktır. Deneyimlerimizi sunmak amacıyla kliniğimizde alt ekstremite DVT nedeniyle tedavi edilen hastaları retrospektif olarak inceledik. Gereç ve Yöntem: Kliniğimize 2002- 2006 tarihleri arasında alt ekstremitelerinde ağrı ve şişlik şikayeti ile başvuran 212 hastaya Wells skorlaması uygulandı. Wells skoru 2' nin üzerinde olan hastalara doppler ultrasonografi çekildi. Tromboz saptadıklarımız hospitalize edildi. Bulgular: Tüm hastaların Wells skoru 2' nin üzerindeydi ve çekilen doppler ultrasonografi sonucunda 173 (%81.6) hastada DVT tespit edildi. Tromboz saptanan olguların 88'i kadın (%50.9), 85'i erkek (%49,1) olup ortalama yaş 48 idi. DVT oluşumunda 36 (%20.8) hastada belirli bir risk faktörü bulunamazken belirlenen risk faktörlerinden en sık olarak 28'inde (%16.2) obstetrik nedenler ve 28'inde (%16.2) immobilizasyon tespit edilmiştir. Olguların 88'ine (%50.9) standart heparin infüzyonu, 79'una (%45.7) ise günde 2 kez düşük molekül ağırlıklı heparin uygulandı. Massiv iliyak trombozlu 6 (%3.4) hastaya ise trombolitik tedavi verildi. Hastaların 4'ünde (%2.3) pulmoner emboli gelişti. Bu hastalardan 2'si massif pulmoner emboli nedeniyle kaybedildi (%1.1). Sonuç: Komplikasyonlarının önlenmesi açısından klinik olarak DVT düşünülen hastalarda doppler ultrasonografi ile tanı kesinleştirilmeli ve erken dönemde uygun tedavi başlanmalıdır.©2008, Fırat Üniversitesi, Tıp Fakültesi

Kaynakça

  • Oger E. Incidence of venous thromboembolism: a community- based study in Western France. EPI-GETBP Study Group. Groupe d'Etude de la Thrombose de Bretagne Occidentale. J Thromb Haemost 2000; 83: 657-660.
  • Brill-Edwards P, Lee A. D-Dimer testing in the diagnosis of acute venous thromboembolism. J Thromb Haemost 1999; 82: 688–694.
  • Bilkay Ö, Çağırıcı U, Engin Ç. Derin ven trombozu ve pulmoner tromboemboli. Duran E (editör). Kalp ve Damar Cerrahisi. 1. Baskı, İstanbul: Çapa Tıp Kitapevi, 2004: 863-878.
  • Heit JA, Silverstein MD, Mohr DN, et al. The epidemiology of venous thromboembolism in the community. J Thromb Haemost 2001; 86: 452-463.
  • Silverstein MD, Heit JA, Mohr DN ve ark. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998; 158: 585-593.
  • Heim SW, Schectman JM, Siadaty MS, Philbrick JT. D-dimer testing for deep venous thrombosis: a metaanalysis. Clin Chem 2004; 50: 1136-1147.
  • Hyers TM, Agnelli G, Hull RD, et al. Antithrombotic therapy for venous thromboembolic disease. Chest 2001;119:176–193.
  • LaPorte D, Farber S ,Sorin S, et al. When deep venous thrombosis fails to respond to therapy. J Am Board Fam Pract 2003;16:246- 250.
  • Blum A, Roche EA. Endovascular management of acute deep vein thrombosis. J Med. 2005; 118: 31-36.
  • Wells PS, Anderson DR, Rodger M ve ark. Evaluation of D-dimer in the diagnosis of suspected deep vein thrombosis. N Engl J Med 2003; 349: 1227-1235.
  • Wells PS, Anderson DR, Bormanis J, et al. Value ofassessment of pretest probability of deep-vein thrombosis inclinical management. Lancet 1997; 350: 1795– 1798.
  • Kassai B, Boissel JP, Cucherat M, et al. A systematic review of the accuracy of ultrasound in the diagnosis of deep venous thrombosis in asymptomatic patients. J Thromb Haemost 2004; 91: 655-666.
  • Kearon C, Ginsberg JS, Hirsh J. The role of venous ultrasonography in the diagnosis of suspected deep venous thrombosis and pulmonary embolism. Ann Intern Med 1998; 129: 1044-1049.
  • Kearon C, Julian JA, Newman TE, et al. Noninvasive diagnosis of deep vein thrombosis. Ann Intern Med 1998;128:663-677.
  • Tick LW, Ton E, van Voorthuizen T, et al. Practical diagnostic management of the patients with clinically suspected deep vein thrombosis ultrasonography, and D-dimer test. Am J Med 2002; 113: 630-635. probability test, compression
  • Beyer J, Schellong S. Deep vein thrombosis:Current diagnostic strategy. Eur J Inter Med. 2005: 238-246.
  • Ziegler S, Schillinger M, Maca TH, Minar E. Postthrombotic syndrome after primary event of deep venous thrombosis 10 to 20 years ago. Thromb Res. 2001; 101: 23–33.
  • Elliot MS, Immelman EJ, Jeffery P, et al. A comparative randomized trial of heparin versus streptokinase in the treatment of acute proximal venous thrombosis: an interim report of a prospective trial. Br J Surg.1979; 66: 838–843.
  • Arnesen H, Hiseth A, Ly B. Streptokinase or heparin in the treatment of deep vein thrombosis: follow-up results of a prospective study. Acta Med Scand. 1982; 211: 65– 68.
  • Merli G. Anticoagulants in the treatment of deep vein thrombosis. Am J Med. 2005; 118: 13-20.
  • Hull RD, Raskob GE, Brant RF, et al. Optimal therapeutic level of heparin therapy in patients with venous thromboembolism. Arch Intern Med 1992; 152: 1589-1595.
  • Rasche RA, Reilly BM, Guıdry JR, et al. The weight-based heparin dosing nomogram compared with a”Standard care” nomogram:a randomized controlled trial. Ann Intern Med 1993; 119: 874-881.
  • Leizorovicz A. Comparison of the efficacy and safety of low molecular weight heparins and unfractionated heparin in the initial treatment of deep venous thrombosis: an updated meta-analysis. Drugs 1996; 52: 30-37.
  • McRae SJ, Ginsberg JS. Initial treatment of venous
  • thromboemolism. Circulation 2004; 110: 3-9.
  • Lensing AWA, Prins MH, Davidson BL, Hirsh J. Treatment of deep venous thrombosis with low molecular weight heparins: a meta analysis. Arch Intern Med 1995; 155: 601-607.
  • Hull RD, Raskob GE, Pineo, et al. Subcutaneous low-molecular- weight heparin compared with continuous intravenous heparin in the treatment of proximal vein thrombosis. N Engl J Med 1992; 326: 975-982.
  • Weitz JI. Low molecular-weight heparins. N Engl J Med 1997; 337: 688-698.
  • Hirsh J, Warkentin TE, Shaughnessy SG, et al. Heparin and low molecular-weight heparin: mechanisms of action, pharmaco- kinetics, dosing, monitoring, efficacy, and safety. Chest 2001; 119: 64-94.
  • Comerota AJ, Chahwan S. Thrombolytic therapy for Acute Venous Thrombosis.In: Bergan JJ (Editor). The Vein Book. USA, Elsevier academic Pres, 2007: 455-464.
  • Comerota AJ, Gale SS. Operative venous thrombectomy. In: Bergan JJ (Editor). The Vein Book. USA, Elsevier academic Pres, 2007: 405-416.
  • Decousus H, Leizorovicz A, Parent F, et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prevention du Risque d'Embolie Pulmonaire par Interruption Cave Study Group. N Engl J Med. 1998; 338: 409-415.
  • Levine MN, Hirsh J, Gent M, et al. Optimal duration of oral anticoagulation therapy: a randomized trial comparing four weeks with three months of warfarin in patients with proximal deep vein thrombosis. J Thromb Haemost1995; 74: 606-611.
  • Kearon C, Ginsberg JS, Kovacs MJ, et al. Comparision of low- intensity warfarin therapy for long therm prevention of recurrent venous thromboembolism. N Eng J Med 2003; 349: 631-639.
  • Kabul Tarihi:28.06.2007
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Ayhan Uysal Bu kişi benim

Kadir Kaan Özsin Bu kişi benim

Rafet Tok Bu kişi benim

Suna Aydın Bu kişi benim

Oktay Burma Bu kişi benim

Ali Rahman Bu kişi benim

Yayımlanma Tarihi 1 Şubat 2008
Yayımlandığı Sayı Yıl 2008 Cilt: 13 Sayı: 1

Kaynak Göster

APA Uysal, A., Özsin, K. K., Tok, R., Aydın, S., vd. (2008). Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma. Fırat Tıp Dergisi, 13(1), 35-38.
AMA Uysal A, Özsin KK, Tok R, Aydın S, Burma O, Rahman A. Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma. Fırat Tıp Dergisi. Şubat 2008;13(1):35-38.
Chicago Uysal, Ayhan, Kadir Kaan Özsin, Rafet Tok, Suna Aydın, Oktay Burma, ve Ali Rahman. “Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma”. Fırat Tıp Dergisi 13, sy. 1 (Şubat 2008): 35-38.
EndNote Uysal A, Özsin KK, Tok R, Aydın S, Burma O, Rahman A (01 Şubat 2008) Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma. Fırat Tıp Dergisi 13 1 35–38.
IEEE A. Uysal, K. K. Özsin, R. Tok, S. Aydın, O. Burma, ve A. Rahman, “Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma”, Fırat Tıp Dergisi, c. 13, sy. 1, ss. 35–38, 2008.
ISNAD Uysal, Ayhan vd. “Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma”. Fırat Tıp Dergisi 13/1 (Şubat 2008), 35-38.
JAMA Uysal A, Özsin KK, Tok R, Aydın S, Burma O, Rahman A. Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma. Fırat Tıp Dergisi. 2008;13:35–38.
MLA Uysal, Ayhan vd. “Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma”. Fırat Tıp Dergisi, c. 13, sy. 1, 2008, ss. 35-38.
Vancouver Uysal A, Özsin KK, Tok R, Aydın S, Burma O, Rahman A. Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma. Fırat Tıp Dergisi. 2008;13(1):35-8.