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Artroplastide Derin Ven Trombozu Profilaksisinde Aktif ve Erken Hareketin Etkinliği

The Effect of Active and Early Motion in the Prevention of Deep Venous Thrombosis after Arthroplasty

Journal Name:

  • Uludağ Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
The aim of this prospective study was to compare the effectiveness of propyhlaxis with postoperative early mobilization, compressive stocking and aspirin with an another method done with low molecular weigth heparin, aspirin and compressive stockings which are more expensive than the former one. 100 patient who were planned to undergo elective total hip or knee arthroplasty were divided into two groups randomly. In group I, the propyhlaxis was done with early postoperative mobilization (2nd hour), compressive stocking and fourweek 2x300 mg aspirin. The prophylaxis in group II was mobilization in postoperative 1st day, 10 days course of low molecular weigth heparin, compressive stocking and four-week aspirin. All patients were evaluated by venography or doppler ultrasonography at postoperative 5.-7. days. The proximal thrombus was present in 2 (%4) patients, asymptomatic distal thrombus was detected in 6 patients in group I. There were 1 (%2) patient with proximal DVT, 3 (%6) patients with symptomatic distal DVT and 3 with asymptomatic distal DVT in group II (p>0.05). We conclude that prophylaxis done with postoperative 2nd hour mobilization, compressive stocking and aspirin is an effective and cheap method to prevent thromboembolic complications.
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Abstract (Original Language): 
Çalışmamızda, primer total kalça ve diz artroplastisi uygulanan olgularda DVT profilaksisi için kullanılan farmakolojik ajanlardan düşük molekül ağırlıklı heparin ile mekanik olarak etki yapan ameliyat sırasında pasif hareket ve ameliyat sonrası erken dönemde mobilizasyon uygulanmasının DVT proflaksisinde etkisinin prospektif olarak karşılaştırılması amaçlandı. Bu prospektif çalışmada tek taraflı primer total kalça veya total diz artroplastisi uygulaması planlanan 100 hasta randomize olarak 2 gruba ayrıldı. Grup I’de; profilaksi için ameliyat sırasında kalça ve diz eklemine pasif hareket yaptırılıp ameliyat sonrası 2. ve 6. saatte mobilizasyon yapılırken Grup II’de ise ameliyat öncesi 12. saatte başlayıp ameliyat sonrası 10 gün devam eden düşük molekül ağırlıklı heparin uygulandı. Her iki gruba da varis çorabı ve 4 hafta süre ile 2x300 mg aspirin verildi. Her iki gruptaki hastalar ameliyat sonrası 4.-7. günlerde venografi ya da renkli doppler ultrasonografi ile değerlendirildi. Grup I’de olguların 8’inde (%16), Grup II’de ise 7’sinde (%14) DVT tespit edildi. DVT gelişimi grup I’deki olguların 2’sinde (%4) proksimal, 6’sında (%12) asemptomatik distal yerleşimli idi. Grup II’de olguların 1’inde (%2) proksimal, 3’ünde (%6) semptomatik distal DVT ve 3’ünde ise (%6) asemptomatik distal DVT saptandı (p>0.05). Sonuç olarak TKA ve TDA uygulamalarında ameliyat sırasında pasif hareket ve ameliyat sonrası erken dönemde mobilizasyonun DVT gelişimini en az düşük molekül ağırlıklı heparin kullanımı kadar engellemesi, profilaktik farmakolojik ajanların neden olabileceği yan etkileri içermemesi ve ek maliyet getirmemesi nedeni ile artroplasti ameliyatlarında DVT profilaksisi için tercih edilebilecek bir yöntem olduğu kanısındayız
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