Author/Editor		Vene, Nina
Title		Zdravljenje akutne venske tromboze
Translated title		Treatment of acute deep venous thrombosis
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 2
Publication year		2000
Volume		str. 29-36
Language		slo
Abstract		Early treatment of venous thrombosis is very important as most complications, such as pulmonary embolism, recurrent venous thrombosis and bleeding, occur in the early period. Until recently, the standard treatment for patients with venous thromboembolism was in hospital, with continuous intravenous infusion or subcutaneous injections of unfractionated heparin, and monitoring using the activated partial thromboplastin time. Lately, low molecular weight heparin, which has many advantages over unfractionated heparin, has changed the treatment of venous thrombosis dramatically. Its increased bioavailability and prolonged half-life permit once or twice daily subcutaneous injections and dosage based on body weight without the need for laboratory monitoring. The treatment of venous thrombosis with low molecular weight heparin is as effective and safe as treatment with unfractionated heparin, with a lower incidence of heparin-induced thrombocytopenia and probably also of osteoporosis. The simple use of the drug has provided an opportunity for initial treatment of venous thrombosis to be performed outside hospitals. In a carefull selected group of patients and a well organised outpatient facility, such treatment is safe and effective.
Summary		Učinkovito zgodnje zdravljenje venske tromboze je nadvse pomembno, saj so v tem obdobju zapleti, kot so pljučna embolija, ponovitev venske tromboze in krvavitve, najpogostejši. Do nedavnega smo bolnike z vensko trombozo zdravili v bolnišnici s standardnim heparinom v trajni intravenski infuziji ali v obliki podkožnih injekcij. Takšno zdravljenje moramo nadzirati z laboratorijskimi meritvami aktiviranega parcialnega tromboplastinskega časa. V zadnjih letih se v zdravljenju venske tromboze vse bolj uveljavlja nizkomolekularni heparin, ki ima pred standardnim heparinom številne prednosti. Zaradi boljše biološke razpoložljivosti in daljše razpolovne dobe bolnik prejme zdravilo v obliki podkožnih injekcij enkrat ali dvakrat dnevno in pri odmerjanju glede na telesno težo laboratorijske kontrole niso potrebne. Zdravljenje venske tromboze z nizkomolekularnim heparinom je enako varno in učinkovito kot zdravljenje s standardnim heparinom, tveganje za nastanek trombocitopenije in verjetno tudi osteoporoze pa je manjše. Zaradi preproste uporabe je zdravilo omogočilo pričetek zdravljenja venske tromboze na domu. Pri skrbno izbrani populaciji bolnikov in ustrezni ambulantni oskrbi je takšno zdravljenje varno in učinkovito.
Descriptors		THROMBOPHLEBITIS ACUTE DISEASE HEPARIN HEPARIN, LOW-MOLECULAR-WEIGHT PULMONARY EMBOLISM MONITORING, PHYSIOLOGIC TREATMENT OUTCOME PATIENT SELECTION AMBULATORY CARE OSTEOPOROSIS THROMBOCYTHEMIA, HEMORRHAGIC