Author/Editor		Premuš Marušič, Alenka; Kovačič, Sašo; Mrhar, Aleš; Petrovič, Danijel
Title		Tromboprofilaksa pri kirurških bolnikih s pljučno embolijo in globoko vensko trombozo v Splošni bolnišnici Murska Sobota
Translated title		Thromboprofylaxis in surgical patients with pulmonary embolism and deep vein thrombosis in Murska Sobota General Hospital
Type		članek
Vol. and No.		Letnik 83, št. suppl.
Publication year		2014
Volume		str. I-21-I-29
ISSN		1581-0224 - Zdravniški vestnik
Language		slv
Abstract		Izhodišča: Venska trombembolija je nastanek strdka v globoki veni, ki povzroča popolno ali delno zaporo vene, ki se lahko kaže z globoko vensko trombozo ali pljučno embolijo. Globoka venska tromboza ali posledično pljučna embolija sta pogost zaplet v postoperacijskem obdobju pri kirurških bolnikih. Zato je potrebna ustrezna preventivna terapija za preprečevanje venske trombembolije, ki temelji na uveljavljenih smernicah, ki predpisujejo postopek obravnave bolnika. Namen naše raziskave je bil pregledati ustreznost preventivne terapije za preprečevanje venske tromboze ali pljučne embolije pri kirurških bolnikih, ki so imeli v SBMS od 1.1.2007 do 31.12.2011 diagnosticirano globoko vensko trombozo ali pljučno embolijo kot zaplet po kirurškem zdravljenju in testno skupino primerjati s kontrolno skupino, pri kateri ni bilo globoke venske tromboze ali pljučne embolije po kirurškem zdravljenju. Metode: Pregledali smo smernice za preprečevanja venske trombembolije in ocenili ustrezen izbor zdravil za preprečevanje trombembolije, ustreznost odmerkov in odmernega intervala, kot tudi čas trajanja terapije glede na oceno tveganja bolnika. V testno skupino smo vključili 144 bolnikov, ki so se zdravili na kirurškem oddelku v Splošni bolnišnici Murska Sobota med letom 2007 in 2011 in so imeli kot glavno ali spremljevalno diagnozo Globoka venska tromboza ali Pljučna embolija, ki je bila zaplet kirurške bolezni tekom kirurškega zdravljenja. V kontrolno skupino smo vključili 142 bolnikov, ki so se zdravili na kirurškem oddelku v Splošni bolnišnici Murska Sobota in niso imeli glavne ali spremljevalne diagnoze venska trombembolija. Skupini smo primerjali med seboj. Rezultati: V kontrolni skupini je 77 % bolnikov prejemalo terapijo za preprečevanje venske trombembolije v skladu s smernicami, medtem ko je ta delež v testni skupini znašal 56 %. Med skupinama smo s pomočjo statističnega testa hi-kvadrat dokazali značilno razliko med prejemanjem ustrezne tromboprofilakse (p < 0.05). Zaključki: Glede na ugotovitve naše raziskave lahko zaključimo, da delež bolnikov z ustrezno tromboprofilakso med kirurškimi bolniki še vedno ni optimalen. Ključno za tromboprofilaktično zaščito bolnika je dobra ocena njegovega tveganja in glede na oceno tveganja izbira ustrezne trombo profilaktične terapije. Menimo, da bi bila smiselna uvedba formalne in aktivne strategije za preprečevanje venske trombembolije, kajti na ta način bi zagotovili najustreznejšo zaščito bolnikov s povečanim tveganjem.Overview of thromboprophylaxis in surgical patients with pulmonary embolism and deep vein thrombosis in Murska Sobota General Hospital Background: Venous thromboembolism is the formation of clot in a deep vein, which causes completeor partial obstruction of the vein. This can be shown as a deep vein thrombosis or a pulmonary embolism. Deep vein thrombosis or pulmonary embolism, consequently, are a common complication after surgical procedures. Therefore, the need for appropriate guidelinebased preventive therapy of venous thromboembolism is crucial. The aim of our study was to determine the adequacy of preventive therapy for deep vein thrombosis or pulmonary embolism in surgical patients who were diagnosed with deep vein thrombosis or pulmonary embolism from 1.1.2007 to 31.12.2011 at the Murska Sobota General Hospital as a complication of surgical treatment and to compare the test group with the control group, in which there was no not either deep vein thrombosis or pulmonary embolism after surgical treatment. Methods: We reviewed the guidelines for the prevention of venous thromboembolism and determined the appropriate selection of drugs, the adequacy of dose and dosing interval, and the appropriate duration of therapy based on the risk assessment score provided by the guidelines. In the test group, we included 144 patients who were treated in the surgical department at the Murska Sobota General Hospital between 2007 and 2011 and had deep venous thrombosis or pulmonary embolism as main or associated diagnosis as a complication during surgical treatment. In the control group, we included 142 patients who were treated in the surgical department at the Murska Sobota General Hospital and did not had venous thromboembolism as the principal or accompanying diagnosis. Both groups were compared. Results: In the control group, 77% of patients received thromboprophylaxis according to the guidelines, while the proportion in the test group was 56%. Significant differences receiving adequate thromboprophylaxis (p <0.05) between the two groups were demonstrated with the chi-square test. Conclusion: According to the findings of our study we can conclude that the proportion of patients with adequate thrombo prophylaxis in surgical patients is still not optimal. The key to appropriate thromboprophylaxis is a good risks assessment of the patient and appropriate selection of thromboprophylaxis therapie. We believe, that it would be reasonable to introduce a formal and active strategies for the prevention of venous thromboembolism to provide the most appropriate protection of patients at increased risk.
Descriptors		Venska tromboza Pljučna embolija
Keywords		preprečevanje tromboembolije kirurški bolnik nizkomolekularni heparin statistična obdelava podatkov