Author/Editor		Vene, Nina
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 41, št. Suppl 1
Publication year		2002
Volume		str. 79-84
Language		slo
Abstract		Despite advances in the prevention and treatment of venous thromboembolism, pulmonary embolism remains one of the most preventable causes of death. The prophylactic approach depends on patients' risk factors, summarized in three risk categories: low, moderate and high-risk patients. Only in low-risk patients is no specific prophylaxis recommended apart from early ambulation. In moderate and high-risk patients, unfractionated heparins or low-molecular-weight heparins are most commonly used. Lately, low-molecular-weight heparins, which are more efficient in high-risk patients and have many other practical advances over unfractionated heparin, have taken over the dominant role in prevention of venous thromboembolism. The simple use of the drug provided an opportunity for prolonged out-of-hospital prophylaxis which should be considered in orthopedic and other very high-risk patients. Low-molecular-weight heparins were also recently extensively studied in several medical and high-risk cancer patients. Despite their undisputed efficacy, prophylactic measures are still underused and implementation of practical strategies for prevention of venous thromboembolism in hospitals and after discharge is needed.
Summary		Kljub napredku v preprečevanju in zdravljenju venskih trombembolizmov pljučna embolija ostaja eden izmed najpogostejših vzrokov smrti, ki jih lahko preprečimo. Način preprečevanja je odvisen od prisotnosti dejavnikov tveganja, na osnovi katerih bolnike uvrstimo v tri skupine: skupino bolnikov z majhnim, zmernim in velikim tveganjem. Le pri bolnikih z majhnim tveganjem posebna zaščita pred venskimi trombembolizmi ni potrebna. Bolnike z zmernim ali velikim tveganjem najpogosteje zaščitimo s standardnim ali nizkomolekularnim heparinom. V zadnjem času so nizkomolekularni heparini, ki so učinkovitejši pri bolnikih z velikim tveganjem in imajo pred standarnim heparinom tudi praktične prednosti, prevzeli glavno vlogo v preprečevanju venskih trombembolizmov. Njihova preprosta uporaba je omogočila tudi nadaljevanje profilakse po odpustu iz bolnišnice, za katero se odločimo pri ortopedskih in drugih bolnikih z zelo velikim tveganjem. Nedavno so bili nizkomolekularni heparini preizkušeni tudi pri številnih internističnih bolnikih in visoko rizičnih bolnikih z rakavimi obolenji. Klub nedvomni učinkovitosti se profilaksa še vedno preredko uporablja, zato so potrebne jasne in enostavne usmeritve za preprečevanje venskih trombembolizmov med zdravljenjem vbolnišnici in po njem.
Descriptors		THROMBOPHLEBITIS PULMONARY EMBOLISM HEPARIN HEPARIN, LOW-MOLECULAR-WEIGHT