Author/Editor		Ponikvar, Mario
Title		Preprečevanje venskih tromboembolizmov po artroplastiki kolka in kolena: podaljšana uporaba nizkomolekulranih heparinov
Translated title		Prevention of venous thromboembolism after total hip and knee arthroplasties: prolonged use of low-molecular-weight heparins
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 41, št. Suppl 1
Publication year		2002
Volume		str. 63-6
Language		slo
Abstract		Venous thromboembolism is the gravest complication of total hip and knee arthroplasties. Its occurrence is contributed to by limb position and release of tissue coagulation factors during surgery, and by lack of full weight-bearing during the first postoperative weeks. Low-molecular-weight heparins are the most efficient and safest ways of prevention. The first dose is given preoperatively; prevention lasts until discharge from hospital. However, venous thromboembolism is known to occur even afterwards, particularly following total hip arthroplasty. Prolonged prophylaxis is wise in patients with additional risk: over 70 years of age, history of venous thromboembolism, increased body weight, varicose veins, estrogen therapy, concomitant cancer, thrombophilia. It is thus far not used routinely due to an unclear cost/benefit ratio.
Summary		Venski trombembolizmi (VTE) so najhujši zaplet artroplastike kolka in kolena. K njihovemu nastanku prispeva položaj uda ter sproščanje tkivnih faktorjev koagulacije med operacijo ter odsotnost polnega obremenjevanja operirane noge v prvih tednih po operaciji. Za njihovo preprečevanje so najbolj učinkoviti in varni nizkomolekularni heparini. Prvi odmerek dobi bolnik pred operacijo, pooperativna tromboprofilaksa pa traja do odpusta iz bolnišnice. Zlasti po artroplastiki kollca lahko pride do VTE tudi po odpustu iz bolnišnice. Podaljšana tromboprofilaksa do 35. pooperativnega dne je zato smiselna pri bolnikih z dodatnim tveganjem: starost nad 70 let, anamneza venskih trombembolizmov, debelost, varikozne vene, estrogensko zdravljenje, rakava bolezen, trombofilija. Nejasno pa je razmerje cena/korist, zato je zaenkrat še ne uporabljamo rutinsko.
Descriptors		KNEE PROSTHESIS HIP PROSTHESIS POSTOPERATIVE COMPLICATIONS THROMBOPHLEBITIS HEPARIN HEPARIN, LOW-MOLECULAR-WEIGHT