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Ameliyat Sonrası Tromboembolik Olayların Profilaksi ve Tedavisinde Güncel Yaklaşım

Current approach in the prophylaxis and treatment of postoperative thromboembolic events

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 1998

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Damage to intima of the vein, stasis of the blood, and tendency for coagulation are the main factors in development of deep venous thrombosis, particularly after surgery. Deep venous thrombosis was identified in 30 to 60% of the cases following operations by utilizing 125I fibrinogen labeling of the thrombus. The thromboembolic diseases occuring after surgery are the main factors for morbidity and mortality. The most common signs of deep venous thrombosis are swelling, tenderness of the foot, and the Homans' sign. Phlebography and Doppler ultrasound are important diagnostic tools. Mechanical preventions such as application of elastic bandages to avoid development of thrombus are useful. Prophylactic subcutaneous heparin is administered 2 hours before and 8-12 hours after the operation. Recently the use of low-molecule heparin is becoming popular. Oral anticoagulant treatment for 6 months is necessary in order to prevent recurrences. Nevertheless, the key points to prevent occurrence of thromboembolic events are determination of the risk factors and application of the optimal prophylaxis. [Journal of Turgut Özal Medical Center 1998;5(1):105-109]
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Abstract (Original Language): 
Ven intimasında harabiyet, staz ve kanın pıhtılaşma özelliğindeki artış, ameliyat ve ameliyat sonrası derin ven trombozunun sebepleri olarak gösterilmiştir. Yapılan çalışmalarda f25 fibrinojen kullanılarak trombüsün işaretlenmesi ile vakaların %30-60'nnda derin ven trombozu tespit edilmiştir. Ameliyat sonrası dönemde görülebilen tromboembolik olaylar önemli morbidite ve mortalite sebepleridir. Derin ven trombozunun tanısında en önemli bulgular şişlik, hassasiyet ve Homans belirtisidir. Tanı yöntemleri arasında flebografi ve Doppler ultrmonografi önemli yer kaplamaktadır. Ameliyat sonrası bacak venlerindeki pıhtı oluşumunu engellemek amacı ile elastik bandaj uygulaması gibi çeşitli mekanik önlemler yararlıdır. Heparin, ameliyat öncesi profilaksi amaçlı uygulamalarda subkütan olarak ameliyattan 2 saat önce ve 8-12 saat sonra verilmektedir. Tromboembolik olayların tedavisinde küçük moleküllü heparin kullanımı yaygınlaşmıştır. Rekürensi önlemek amacıyla heparin tedavisini takiben 6 ay süreyle oral antikoagülan tedavi gerekmektedir. Tromboembolik olayların önlenmesi için risk faktörlerinin belirlenip en uygun profilaksinin verilmesi kilit noktalardır. [Turgut Özal Tıp Merkezi Dergisi 1998;5(1):105-109]
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  • 1
105-109
  • Turkish

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