Author/Editor     Azarija, Jelena; Peternel, Polona
Title     Ambulantno zdravljenje venske tromboze
Translated title     Outpatient tratment of venous thrombosis
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 78, št. 3
Publication year     2009
Volume     str. 123-8
Language     slo
Abstract     Background Authors present the preliminary results of ambulatory treatment of vein thrombosis (VT) at the University Medical Centre Ljubljana Department of Vascular Diseases. In Slovenia ambulatory treatment of VT in form of a daily hospital has been carried out since 2005. Patients and methods From October 2005 to December 2006 we retrospectively reviewed 395 consecutive patients, treated for VT of lower or upper limbs. Diagnosis of VT was confirmed by ultrasound imaging. The physician on duty decided whether the patient will be treated in hospital or as an outpatient, on the ground of his/her clinical condition and compliance in the treatment process. Results In the ambulatory treated group were 198 patients (108 men and 90 women), aged 58 (42.72) years. In the hospital treated group there were 197 patients (91 men and 106 women), aged 73 (57.80) years. Patients treated in the hospital were older than patients treated ambulatory, had more frequently associated pulmonary embolism (PE), malignancies and immobilization. In the latter group, the use of oral contraceptives and hormone replacement therapy was significantly more frequent. The time needed to achieve the therapeutic range of INR (2.0.3.0) was longer in the ambulatory treated group. More patients were admitted to the ambulatory treatment during weekdays and more patients were admitted to the hospital on weekends and during holidays. More patients admitted to the ambulatory treatment were from Ljubljana and more patients admitted to the hospital were from more distant locations. In the ambulatory treated group none of the patients had complications during the acute phase of VT. Seven patients treated in hospital survived complications: two massive PE, five major bleeding. Eight patients treated in hospital died: four had PE, two septic shock, one heart failure and one terminal malignancy. (Abstract truncated at 2000 characters)
Summary     Izhodišča Ambulantno zdravljenje akutne venske tromboze (VT) smo na Kliničnem oddelku za žilne bolezni Kliničnega centra v Ljubljani uvedli leta 2005. Avtorici predstavljata izsledke ambulantnega zdravljenja VT v obdobju od oktobra 2005 do decembra 2006 in jih primerjata z bolnišničnim zdravljenjem. Bolniki in metode V retrospektivno raziskavo smo vključili 395 zaporednih bolnikov, ki so se zdravili zaradi ultrazvočno potrjene VT spodnjih ali zgornjih udov. Sprejemni zdravnik se je glede na oceno bolnikove pripravljenosti za sodelovanje in kliničnega stanja odločil za ambulantno ali bolnišnično zdravljenje. Rezultati V ambulanti smo zdravili 198 bolnikov (108 M in 90 .), starih od 42.72 let (mediana 58 let). V bolni.nici smo zdravili 197 bolnikov (91 M in 106 Ž), starih od 57 do 80 let (mediana 73 let). Bolniki, zdravljeni v bolnišnici, so bili starejši od ambulantno zdravljenih bolnikov, imeli so pogosteje pridruženo pljučno embolijo (PE), novotvorbo, pogosteje so bili ovirani v gibanju. Ambulantno zdravljene ženske so pogosteje uporabljale oralne kontraceptive in hormonsko nadomestno zdravljenje v meni. Čas, ki je bil potreben za dosego INR 2,0.3,0, je bil daljši pri ambulantno zdravljenih. Več bolnikov je bilo sprejetih v ambulantno zdravljenje na delavnike, v bolnišnico pa na dela prost dan. V ambulantno obravnavo je bilo sprejetih več bolnikov iz Ljubljane in bližnje okolice, v bolnišnico pa več iz oddaljenih krajev. Med ambulantno zdravljenimi ni bilo zapletov, med bolnišnično zdravljenimi je preživelo zaplet 7 bolnikov (2 PE, 5 pomembno krvavitev). Med bolnišnično zdravljenimi je 8 bolnikov umrlo (4 zaradi PE, 2 zaradi septičnega šoka, 1 zaradi srčnega popuščanja, 1 zaradi novotvorbe). Zaključki Odločitev o ambulantnem zdravljenju VT je odvisna od bolnikovega stanja, njegove pripravljenosti za sodelovanje in ustrezne organiziranosti zdravstvene službe.
Descriptors     POLYCYSTIC OVARY SYNDROME
ATHEROSCLEROSIS
ENDOTHELIUM, VASCULAR
INSULIN RESISTANCE
CARDIOVASCULAR DISEASES
RENIN-ANGIOTENSIN SYSTEM
OBESITY
ADIPOSE TISSUE