Periferik Venöz Katater Uygulanan Hastalarda Üst Ekstremite Ven Trombozunun Doppler Ultrasonografi ile Değerlendirilmesi

Year 2023, , 179 - 183, 30.06.2023

Habibe Hezer , Hatice Kılıç , Sevim Öğülmüş , Funda Karaduman Yalçın , Hatice Canan Hasanoğlu

https://doi.org/10.53446/actamednicomedia.1151453

Abstract

Amaç: Periferik venöz kataterler (PVK), damar duvar hasarı nedeniyle venöz tromboz riskini artırabilir. Çalışmanın amacı, PVK’lerin çoğu üst ekstremitelere uygulandığı için, PVK'ya bağlı üst ekstremite venöz tromboz (ÜEVT) vakalarını belirlemektir.
Yöntem: Bir aylık süreçte göğüs hastalıkları kliniğinde yatan hastalardan PVK'sı olan veya başvurusundan önce hastane yatışında PVK öyküsü olan 69 hasta bu prospektif çalışmaya dahil edildi. PVK’ya bağlı trombüs oluşumunu değerlendirmek için tüm hastalara üst ekstremite Doppler, kompresyon ultrasonografi (USG) tetkiki yapıldı. ÜEVT olan olgular grup 1, ÜEVT olmayan olgular ise grup 2 olarak değerlendirildi. Demografik parametreler ve intravenöz tedaviler (İV) gruplar arasında karşılaştırıldı.
Bulgular: Altmış dokuz hastanın 26'sında (%37,7) Doppler USG ile ÜEVT tanısı kondu. On hastada (%14,5) alt ekstremite ven trombozu tespit edildi. Yirmi altı hastanın 14'ünde (%53,8) sefalik vende ve dört hastada (%15,4) bazilik vende ÜEVT görüldü. Derin ÜEVT iki olguda (%2,9) aksiller ve brakiyal venlerde; yüzeyel ÜEVT 24 olguda (%34,8) izlendi. Seftriakson, sefoperazon / sulbaktam ve esomeprazol, ÜEVT ile en çok ilişkili İV tedavilerdi. Sadece kan almak için PVK uygulanan beş hastada ÜEVT izlendi.
Sonuç: Çalışmamızın sonuçları, hastaların yaklaşık 1/3'ünde Doppler USG incelemesi ile ÜEVT tespit edildiği için PVK'nın ÜEVT için bir risk faktörü olduğunu göstermiştir. PVK'ya gereksinim kalmadığında veya intravenöz tedavi ihtiyacı azaldığında, oral tedavi planlanmalı ve PVK çıkarılmalıdır. ÜEVT'den kaçınmak için PVK'nın çıkarılması gerekli görünmektedir.

Keywords

Periferik venöz katater, üst ekstremite ven trombozu, Doppler ultrasonografi, intravenöz tedavi

Supporting Institution

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Thanks

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Evaluation of Upper Extremity Venous Thrombosis with Doppler Ultrasonography in Peripheral Venous Line Applied Patients

Abstract

Objectives: Peripherally inserted venous lines (PVL) may increase the risk of venous thrombosis due to vessel wall disarrangement. Aim of this study is to identify the cases of upper extremity venous thrombosis (UEVT) related to PVL since most of the PVLs applied to upper extremities.
Methods: Sixty-nine hospitalized patients with previous or present PVL insertions were included in this prospective study. Upper extremity Doppler compression ultrasonography (USG) examination were performed to on all patients. The cases with detected UEVTs were evaluated as group 1 and the remaining cases were evaluated as group 2. Demographic parameters, PVL applications, intravenous treatments were compared between the groups.
Results: UEVT was diagnosed by Doppler USG in 26 (37.7%) patients out of 69 patients. Lower extremity thrombosis was found in 10 (14.49%) patients. UEVT was observed in cephalic vein in 14 (53.8%) and in basilic vein in four (15.4%) out of 26 (37.7%) patients. Axillary and brachial deep UEVT was located in two (2.9%) cases. Superficial UEVT was found in 24 (34.8%) cases. Ceftriaxone, cefoperazone/sulbactam and esomeprazole were the mostly associated treatments with UEVT. UEVT was detected in five patients with PVL that were inserted only for drawing blood.
Conclusion: PVL is a risk factor for UEVT since almost 1/3 of the patients revealed UEVT. When PVL is no longer needed or the need for intravenous therapy decreases, oral therapy should be planned and PVL should be removed. Removal of PVL appears to be necessary to avoid UEVT.

Keywords

Peripheral venous line, upper extremity venous thrombosis, Doppler ultrasonography, intravenous therapy

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