Postoperatif Dönemde D-Dimer Seviyeleri

Öz

Amaç: D-dimer pulmoner tromboemboli tanısında en sık kullanılan ve oldukça hızlı sonuçlanan bir testtir. Fibrin yıkım ürünü olan D-dimer pulmoner tromboemboli dışında travma, postoperatif dönem, akut ve kronik bazı hastalıklarda da yükselmektedir. Literatürde postoperatif dönemde D-dimer yüksekliğiyle ilgili yeterli çalışma bulunmamaktadır. Bu çalışmanın amacı postoperatif D-dimer yüksekliğini ve hangi günlerde bu yüksekliğin ortaya çıktığını tespit etmektir. Gereç ve Yöntemler: Çalışmaya elektif şartalarda öpere edilen 59 hasta alındı. Hastaların hepsi 40 yaşın üzerindeydi ve preoperatif ve postoperatif 1. günde düşük molekül ağırlıklı heparin profilaksisi uygulandı. Hastaların D-dimer düzeyleri preoperatif ve postoperatif 1, 3, 7 ve 15 günlerde latex aglü-tinasyon testi ile değerlendirildi. Bulgular: Öpere hastaların dağılımı: Multinodüler guatr (13), kolelitiazis (12), inguinal herni (10), pilonoidal sinüs (6), insizyonel herni (5), diğerleri (13). D-dimer düzeyleri preoperatif 0,186±0,344 mg/L, postoperatif 1. günde 0.312 ± 0.346 mg/L, postoperatif 3. günde 0.307 ± 0.410 mg/L, postoperatif 7. günde 0.289 ± 0.443 mg/L and postoperatif 15. günde 0.271 ± 0.527 mg/L'di. Postoperatif D-dimer düzeyleri preoperatif düzeyle karşılaştırıldığında 1. ve 3. günlerde istatistiksel olarak anlamlı yüksek bulundu (p< 0.001, p< 0.001, sırasıyla). Sonuç: Sonuç olarak postoperatif dönemde D-dimer yüksekliği tek başına pulmoner tromboemboli tanısını koymada yetersizdir. Ayşegül KARALEZLİ, H. Canan HASANOĞLU, Recep AYDIN, Mükremin ER, Ebru Şengül ŞEREF PARLAK, Ahmet KUŞDEMİR,

Anahtar Kelimeler

• Venöz tromboemboli
• postoperatif dönem
• D-dimer

D-Dimer Levels Mostly Elevated on the Postoperative First Week

Öz

Objective: D-dimer has become one of the frequently used parameters in the diagnosis of pulmonary thromboembolism as it is a rapidly resulted test. D-dimer, as it is a fibrin degradation product, can also elevate in trauma, postoperative period, some acute and chronic diseases beside pulmonary thromboembolism. In literature, there is not enough study about D-dimer elevation in postoperative period. The purpose of our study is to determine postoperative D-dimer increase and show in which days this increase occurs. Material and Methods: Electively operated 59 patients were included into this study. All patients over 40 years old were administered prophylaxis by low molecular weight heparin in preoperative and postoperative first days. We evaluated D-dimer levels of patients by using latex agglutination test on the first day of preoperative and postoperative 1st, 3rd, 7th and 15th days. Results: The dispersal of operated patients: Multinodular goiter (13), cholelithiasis (12), inguinal hernia (10), pilonidal sinus (6), incisional hernia (5), others (13). D-dimer levels were 0,186±0,344 mg/L preoperatively, 0,312±0,346 mg/L on postoperative 1st days, 0,307±0,410 mg/L 3rd day, 0,289±0,443 mg/L 7th day and 0,271±0,527 mg/L 15th day. D-dimer levels were found significantly higher on the 1st and 3rd days when compared to preoperative levels (p<0.001, p<0.001, respectively). Conclusion: As a result in the postoperative period D-dimer test is inadequate for the diagnosis of pulmonary embolism.

Anahtar Kelimeler

• Venous thromboembolism; postoperative period; fibrin fragment D
• fibrin fragment D
• postoperative period;

Kaynakça

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