Liječenje venskih tromboembolija

master's thesis

• Title (english): Treatment of venous thromboembolism
• Author: Ivan Bagarić
• Mentor: Ana Boban (mentor)
• Committee member: Robert Likić (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Ana Boban (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Venska tromboembolija je multifaktorska bolest koja obuhvaća duboku vensku trombozu (DVT) i plućnu emboliju (PE). Bolest se očituje pojavom ugruška u dubokim venama te PE ukoliko dođe do otrgnuća tromba koji tada kao embolus putuje do plućnih arterija. Postupak kojim dijagnosticiramo VTE obuhvaća anamnezu, fizikalni pregled, laboratorijske pretrage te slikovne metode. Liječenje VTE sastoji se od primjene antikoagulantnih lijekova, heparina, antagonista vitamina K i zadnjih godina direktnih oralnih antikoagulantnih lijekova (DOAK). Cilj ovog retrospektivnog istraživanja bio je utvrditi mijenja li dostupnost DOAK-a način liječenja DVT-a. Proveli smo istraživanje o načinu liječenja DVT-a u kojem smo uključili sve bolesnike kojima je u tromjesečnom razdoblju od svibnja do srpnja 2015. godine, te u istom razdoblju 2017. godine postavljena dijagnoza DVT u hitnoj službi. Naši rezultati pokazali su da se nakon stavljanja DOAK-a na listu HZZO-a povećala uporaba DOAK-a u s 15% u 2015. godini na 38% u 2017. Također smo pokazali da su se DOAK češće primjenjivali kod mlađih bolesnika te onih koji su liječeni ambulantno. Naše istraživanje pokazalo je da DOAK postupno zamjenjuju varfarin u liječenju DVT, iako je varfarin i dalje najčešće primjenjivani antikoagulans.

Abstract (english)

Venous thromboembolism (VTE) is a multifactorial disease which combines deep vein thrombosis (DVT) and pulmonary embolism (PE). The main characteristic of VTE is the presence of clots in the deep veins. If the clot detaches it can block pulmonary arteries and cause PE. Diagnostic approach is based on medical history, physical examination, laboratory tests and medical imaging. VTE can be managed by using anticoagulant therapy such as heparin, vitamin K antagonist and direct oral anticoagulants (DOAC). The aim of this retrospective study was to evaluate change in the approach to treatment of DVT after increasing availability of DOACs. We have retrospectively analysed patients diagnosed with DVT from May to July 2015 and 2017 at the emergency ward. The results had shown that the usage of DOAC was more common 2017 (38%) comparing to the same period of time in 2015 (15%). DOAC were also more commonly used in younger patients and in those who were treated ambulatory. Despite the fact that DOAC are equally effective and safe as warfarin they did not fully replaced the usage of warfarin.

• Keywords: venska tromboembolija; DOAK; varfarin; liječenje
• Keywords (english): venous thromboembolism; DOAC; warfarin; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:167776
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-01-04 08:21:10