Author/Editor		Poredoš, Pavel; Peternel, Polona
Title		Preprečevanje venske tromboze in pljučne embolije
Translated title		Prevention of venous thrombosis and pulmonary embolism
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 2
Publication year		2000
Volume		str. 9-14
Language		slo
Abstract		The paper discusses risk factors for venous thrombosis, assessment of risk to individual patients from thromboembolic complications and possible methods for preventing venous thrombosis and pulmonary embolisms. Old age, cancer, orthopedic surgery, inherited or acquired thrombophilia and immobility increase the risk of venous thromboembolic complications. Patients with a low risk of venous thromboembolisms do not require pharmacological prophylaxis of venous thromboembolisms, but rather early mobilisation after surgery, compressive stockings or other means of physical therapy. In addition to non-pharmacological prophylaxis, patients with a moderate risk or high risk of venous thromboembolism also require pharmacological prophylaxis of venous thromboembolisms. Standard unfractionated heparin and low molecular weight heparin are available. In patients at moderate risk of venous thromboembolisms, the efficacy of standard and low molecular weight heparin is comparable, but low molecular weight heparin is more efficient in patients at high risk (orthopaedic patients, patients with cerebrovascular incidents and patients with polytrauma). Aspirin, dextran and low dose warfarin are less effective than heparin. In patients with an increased risk of bleeding, intermittent pneumatic compression of the legs is used instead of heparin. Patients with a very high risk of venous thromboembolisms (surgery of the knee or hip) require a combination of low molecular weight heparin and intermittent pneumatic compression of the legs. (Abstract truncated at 2000 characters.)
Summary		V prispevku so predstavljeni dejavniki tveganja, ogroženost posameznih skupin bolnikov in možni načini preprečevanja venske tromboze in pljučne embolije. Dejavnike tveganja za vensko trombozo in pljučno embolijo razdelimo v tri skupine. Prva skupina zajema splošne klinične dejavnike, druga prirojeno ali pridobljeno trombofilijo, tretja pa vrsto operacij in način anestezije. Glede na prisotnost dejavnikov tveganja ločimo bolnike v skupino majhne, zmerne, velike in zelo velike ogroženosti pred nastankom venske tromboze in pljučne embolije. Izbira postopkov za preprečevanje venske tromboze in pljučne embolije je odvisna od ocene stopnje ogroženosti. Pri osebah z majhnim tveganjem uporaba zdravil ni potrebna, zadošča že zgodnje vstajanje po operacijah. Bolniki z zmernim, velikim ali zelo velikim tveganjem za nastanek venske tromboze in pljučne embolije potrebujejo zaščito z zdravili. Sredstvo izbora za preprečevanje venske tromboze in pljučne embolije je heparin. Na voljo imamo standardni nizkomolekularni heparin. Pri zmerno ogroženih bolnikih je učinkovitost obeh heparinov primerljiva, pri bolnikih z zelo velikim tveganjem pa je nizko molekularni heparin učinkovitejši od standardnega. Druga zdravilna sredstva kot aspirin, dextran in majhni odmerki oralnih antikoagulacijskih sredstev so manj učinkovita kot heparin. V primeru povečanega tveganja za krvavitev namesto heparina uporabimo mehansko zaščito-intermitentno pnevmatično kompresijo. (Izvleček prekinjen pri 2000 znakih).
Descriptors		THROMBOPHLEBITIS PULMONARY EMBOLISM RISK FACTORS PATIENT SELECTION HEPARIN ASPIRIN DEXTRANS BANDAGES POSTOPERATIVE CARE