Ayhan UYSAL, Kadir Kaan ÖZSİN, Rafet TOK, Suna AYDIN, Oktay BURMA, Ali RAHMAN

Alt Ekstremite Derin Ven Trombozunda Medikal Tedavi: Retrospektif Çalışma

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

Anahtar Kelimeler:

Derin ven trombozu, dopler ultrasonografi, heparin

Medical Treatment of Lower Extremity Deep Vein Thrombosis: Retrospective Study

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

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Kabul Tarihi:28.06.2007