Melike Elif TEKER, Feyzullah GÜMÜŞÇÜ, Mehmet Emre ELÇİ

Üst ekstremite derin ven trombozlu hastaların değerlendirilmesi

Amaç: Üst ekstremite derin venöz trombozları artan in - vazif vasküler girişimlere paralel olarak daha sıkça karşımıza çıkmaktadır. Bu çalışmada risk faktörleri, bulguları, tanısı ve tedavisi ile klinik gidişatını incelediğimiz üst ekstremite derin venöz tromboz (UEDVT) olgularımızı retrospektif olarak değerlendirmeyi amaçladık. Yöntemler: 2012 Ocak-2014 Mayıs tarihleri arasında Doppler ultrasonografi ile tanısı doğrulanan 23 derin venöz trombozlu olgu çalışmamıza dahil edilmiştir. Tüm hastaların risk faktörleri ve altta yatan hastalıkları sorgulanarak, üst ekstremite venöz Doppler ultrasonografik görüntülemeleri yapıldı. Olguların 15inde (%65,2) santral venöz kateter mevcut olup bu risk faktörü en sık karşılaşılan UEDVT nedeniydi. Bulgular: Düşük molekül ağırlıklı heparin (DMAH) ve sonrasında ortalama 6 ay süreyle oral antikoagülan protokolü uygulandı. Tüm hastalar 2 aylık periyotlarla bir yıl süresince poliklinik takibinde tutuldu. Altta yatan hastalıklarına bağlı olarak 5 (%21,7) olgu takip periyotları tamamlanamadan kaybedildi. Pulmoner emboli komplikasyonu ve nüks DVT görülmedi. Hiçbir olguda takip süresince post-trombotik sendrom gelişmedi. Sonuç: Tedavide amaçlanan; semptomları giderme, nüksleri önleme ve tedavi süresi ile maliyetleri sınırlama amacıyla DMAHların uygulama kolaylığının yanısıra etkinliği ve kanama riskinin azlığı nedeniyle standart heparine tercih edilerek yüz güldürücü sonuçlar alınacağı kanaatindeyiz.

Evaluation of patients with upper extremity deep vein thrombosis

Objective: The incidence of upper limb deep vein throm - bosis is rising in parallel with more frequent invasive vas - cular procedures. In this study we aimed to evaluate the upper limb deep vein thrombosis (ULDVT) cases retro- spectively according to risk factors, symptoms, diagnosis and clinical course. Methods: Between January 2012 and May 2014, we studied 23 deep vein thrombosis cases which were con - frmed with Doppler ultrasound. The patients were ques - tioned about risk factors and underlying diseases and were examined with upper extremity venous Doppler ultrasonography. 15 cases had (65.2%) central venous catheter being the most common ULDVT reason. Results: Protocol included low molecular weight hepa- rin in the acute phase and then oral anticoagulant for 6 months. All patients were followed at outpatient clinic with 2 month intervals for a year. Before completing the follow- up, 5 patients (21.7%) died of other reasons and we didnt see any pulmonary embolus complication and recurrent DVT. None of the cases had post-thrombotic syndrome during follow-up. Conclusion: We suggest that LMWH must be preferred to standard heparin therapy because of its effectiveness, rare hemorrhage risk and easy usage to relieve symp- toms, prevent recurrences, shorten the therapy period and decrease the costs.

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