İlker KAYA, Mehmet ÇEBER, Cemal ASLAN, İlker AKAR

Alt Ekstremite Derin ven Trombozunda Medikal Tedavi: Retrospektif Çalışma

Amaç: Derin ven trombozu (DVT) zamanında teşhis edilip tedavi edilmediği zaman ciddi morbidite ve mortalite ile sonuçlanabilen bir hastalıktır. İlimiz devlet hastanesi kalp ve damar cerrahisi polikliniğine başvuran alt ekstremite DVT nedeniyle tedavi edilen hastalar retrospektif olarak incelendi.Gereç ve Yöntem: Kliniğimize Ocak 2010 - Aralık 2016 tarihleri arasında alt ekstremitelerinde ağrı ve şişlik şikayetleri ile başvuran 424 hastaya Wells skorlaması uygulandı. Wells skoru 2' nin üzerinde olan hastalara alt ekstremite renkli venöz doppler ultrasonografi çekildi. DVT tanısı alanlar yatırıldı.Bulgular: Tüm hastaların Wells skoru 2'nin üzerindeydi ve çekilen doppler ultrasonografi sonucunda 323 (%76,1) hastada DVT tespit edildi. Tromboz saptanan olguların 165’i kadın (%51), 158’i erkek (%48,9) olup ortalama yaş 57 idi. DVT oluşumunda 77 (%23.8) hastada belirli bir risk faktörü bulunamazken, belirlenen risk faktörlerinden en sık olarak 56’sında (%17,3) obstetrik nedenler ve 56’sında (%17,3) immobilizasyon tespit edilmiştir. Olguların 157’ sine (%48,6) standart heparin infüzyonu, 154’üne (%47,6) ise günde 2 kez düşük molekül ağırlıklı heparin uygulandı. Massiv iliyak trombozlu 12 (%3,7) hastaya ise trombolitik tedavi verildi. Hastaların 8’inde (%2.4) pulmoner emboli gelişti. Bu hastalardan 4’ü massif pulmoner emboli nedeniyle kaybedildi (%1.2).Sonuç: Komplikasyonlarının önlenmesi açısından klinik olarak DVT düşünülen hastalarda doppler ultrasonografi ile tanı kesinleştirilmeli ve erken dönemde uygun tedavi başlanmalıdır.

Anahtar Kelimeler:

Derin ven trombozu, Doppler 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 world wide 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 January2010- December, 2016; 424 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 wells scoreing is higher than 2, patients were examined with lower extremity venous doppler ultrasonography. The ones at whom thrombosis were detected, were hospitalized.Results: It was found that Wells score of all patients was above 2 and DVT was observed in 323 patients (76,1%). 165 patients (51%) were females and of the 158 patients (48,9%) were males, and avarage age 57. There was no risk factors for DVT in the 77 (23,8%) patients. The most common risk factors for DVT were obstetric causes in 56 patients; (17,3%) and immobilization in 56 patients (17,3%). Standart heparin infusion was administered to 157 patients (48,6%) while the remaining patients 154 (47,6%) had low molecular weight heparin twice a day. 12 patients (3.7%) with massive iliac thrombosis were treated with thrombolytic therapy. Pulmonary embolus was developed in the 8 patients (2.4%) and four of them died due to massive pulmonary emboli (1.2%).Conclusion: These data indicate that early suitable treatment of DVT is necessary to prevent its complications after a definitive detection of DVT with a doppler ultrasonography.

Keywords:

Deep vein thrombosis, Doppler Ultrasonography, Heparin,

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