Tromboembolijske komplikacije i profilaksa kod velikih abdominalnih operacija

master's thesis

• Title (english): Thromboembolic complications and prophylaxis in patients undergoing major abdominal surgery
• Author: Margareta Lacković
• Mentor: Tomislav Radočaj (mentor)
• Committee member: Marinko Vučić (predsjednik povjerenstva)
• Committee member: Dinko Tonković (član povjerenstva)
• Committee member: Tomislav Radočaj (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Medicinski pojam tromboembolijske komplikacije podrazumijeva dva entiteta: duboku vensku trombozu i plućnu emboliju. Duboka venska tromboza predstavlja okluziju dubokih vena, najčešće nogu, trombom. Plućna embolija je stanje nastalo iznenadnim smještanjem tromba u dijelu plućne arterije s posljedičnom opstrukcijom plućnog krvotoka. Do tromboembolijskih incidenata dolazi zbog trijasa čimbenika: venske staze, vaskularnog oštećenja i hiperkoagulabilnosti. Najčešći rizični čimbenici su mirovanje, imobilizacija, kirurški zahvat i kirurška trauma što dovodi do krvne staze unutar venskog sustava. Tromboprofilaksa kod velikih abdominalnih operacija indicirana je u bolesnika koji imaju neki od rizičnih čimbenika: imobilizacija, dob, pretilost, maligna bolest, trudnoća, prethodne tromboembolijske komplikacije ili pozitivna obiteljska anamneza. Profilaksa koja se provodi heparinom, značajno smanjuje rizik od tromboembolijskih komplikacija. Preporuča se intravenska primjena nefrakcioniranog heparina ili supkutana primjena niskomolekularnog heparina. Također, smjernice uključuju i nove oralne antikoagulanse. Od nefarmakoloških metoda koriste se što ranija mobilizacija pacijenta, kompresivne čarape te intermitentna pneumatska kompresija donjih ekstremiteta.

Abstract (english)

The medical term for thromboembolic complication includes two entities: deep vein thrombosis and pulmonary embolism. Deep vein thrombosis is the occlusion of deep veins, most often the legs, by a thrombus. Pulmonary embolism is a condition caused by the sudden placement of a blood clot in a part of the pulmonary artery with consequent obstruction of the pulmonary blood flow. Thromboembolic incidents occur due to a triad of factors: venous pathways, vascular damage, and hypercoagulability. The most common risk factors are rest, immobilization, surgery, and surgical trauma leading to blood flow within the venous system. Thromboprophylaxis in major abdominal surgery is indicated in patients who have some of the risk factors: immobilization, age, obesity, malignancy, pregnancy, previous thromboembolic complications, positive family history, etc. Heparin prophylaxis significantly reduces the risk of thromboembolic complications. Intravenous administration of unfractionated heparin or subcutaneous administration of low molecular weight heparin is recommended. Also, the guidelines include new oral anticoagulants. The non-pharmacological methods include the earliest possible mobilization of the patient, compression stockings and intermittent pneumatic compression of lower limbs.

• Keywords: tromboemolijske komplikacije; duboka venska tromboza; plućna embolija; tromboembolijska profilaksa; heparin; novi oralni antikoagulansi
• Keywords (english): thromboembolic complications; deep vein thrombosis; pulmonary embolism; thromboembolic prophylaxis; heparin; new oral anticoagulant
• Language: croatian
• URN:NBN: urn:nbn:hr:105:036091
• 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: 2023-01-17 11:52:38