RESUMO
El tratamiento de las úlceras postrombóticas o posflebíticas constituye un reto para la medicina debido a su cronicidad y a sus frecuentes recidivas que condicionan múltiples trastornos locales y sistémicos, con una mala calidad de vida del paciente. En este trabajo se incluyeron 80 pacientes con úlceras posflebíticas en miembros inferiores que fueron divididos en 2 grupos: 40 tratados con lisados de plaquetas alogénicas conservadas y 40 tratados convencionalmente, que conformaron el grupo control. Se consideró como buen resultado cuando a los 30 días de tratamiento o antes, el paciente presentó una respuesta parcial o total. En el 95 por ciento de los enfermos tratados con el lisado se obtuvo una buena respuesta (suma de las totales y parciales) contra el 75 por ciento en el grupo control (p>0,001). El uso del lisado plaquetario resultó un proceder simple y efectivo en el tratamiento de úlceras posflebíticas en miembros inferiores, que puede ser recomendado, ya que los pacientes pueden mantenerse en sus hogares y así se elimina el costo hospitalario que generalmente tiene el tratamiento de este tipo de lesión(AU)
Treatment of post-thrombotic ulcers or postflebitic is a challenge to medicine because of its chronicity and frequent recurrences that determine multiple local and systemic disorders with poor quality of life for patients. This study included 80 patients with lower limb posflebitic ulcers, who were grouped into 2 groups: 40 treated with preserved allogeneic platelet lysates and 40 were treated conventionally. The latter was the control group. It was considered good result when the patient had a partial or complete response after 30 days of treatment or before. Good response was found in 95 percent of patients treated with lysate (sum of total and partial values) versus 75 percent in the control group (p> 0.001). The use of platelet lysate was a simple and effective procedure in the treatment of lower limb posflebitic ulcers. This treatment can be recommended, since patients can stay at home, thus eliminating the hospital costs incurred in this type of treatment(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Síndrome Pós-Flebítica/epidemiologia , Síndrome Pós-Flebítica/terapia , Fator de Crescimento Derivado de Plaquetas/uso terapêutico , Plaquetas/fisiologiaRESUMO
El tratamiento de las úlceras postrombóticas o posflebíticas constituye un reto para la medicina debido a su cronicidad y a sus frecuentes recidivas que condicionan múltiples trastornos locales y sistémicos, con una mala calidad de vida del paciente. En este trabajo se incluyeron 80 pacientes con úlceras posflebíticas en miembros inferiores que fueron divididos en 2 grupos: 40 tratados con lisados de plaquetas alogénicas conservadas y 40 tratados convencionalmente, que conformaron el grupo control. Se consideró como buen resultado cuando a los 30 días de tratamiento o antes, el paciente presentó una respuesta parcial o total. En el 95 por ciento de los enfermos tratados con el lisado se obtuvo una buena respuesta (suma de las totales y parciales) contra el 75 por ciento en el grupo control (p>0,001). El uso del lisado plaquetario resultó un proceder simple y efectivo en el tratamiento de úlceras posflebíticas en miembros inferiores, que puede ser recomendado, ya que los pacientes pueden mantenerse en sus hogares y así se elimina el costo hospitalario que generalmente tiene el tratamiento de este tipo de lesión
Treatment of post-thrombotic ulcers or postflebitic is a challenge to medicine because of its chronicity and frequent recurrences that determine multiple local and systemic disorders with poor quality of life for patients. This study included 80 patients with lower limb posflebitic ulcers, who were grouped into 2 groups: 40 treated with preserved allogeneic platelet lysates and 40 were treated conventionally. The latter was the control group. It was considered good result when the patient had a partial or complete response after 30 days of treatment or before. Good response was found in 95 percent of patients treated with lysate (sum of total and partial values) versus 75 percent in the control group (p> 0.001). The use of platelet lysate was a simple and effective procedure in the treatment of lower limb posflebitic ulcers. This treatment can be recommended, since patients can stay at home, thus eliminating the hospital costs incurred in this type of treatment
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Fator de Crescimento Derivado de Plaquetas/uso terapêutico , Plaquetas/fisiologia , Síndrome Pós-Flebítica/epidemiologia , Síndrome Pós-Flebítica/terapiaRESUMO
Deep vein thrombosis occurs in up to 50% of children with tunneled central venous catheters (CVCs). CVC-related deep vein thrombosis involving the upper extremity is usually asymptomatic but can result in post-thrombotic syndrome (swelling, pain, skin changes, and functional impairment). In a cohort of childhood cancer survivors evaluated clinically a mean of 7.5 +/- 2.8 years after completion of therapy who previously had CVCs in place for a median 15.5 months, none of 50 patients (95% CI = 0% to 6%) had these features diagnostic of post-thrombotic syndrome. Five patients had arm circumference 3% to 5% greater ipsilateral to the prior CVC.
Assuntos
Cateterismo Venoso Central , Neoplasias/terapia , Síndrome Pós-Flebítica/epidemiologia , Sobreviventes , Adolescente , Braço/anatomia & histologia , Cateterismo Venoso Central/efeitos adversos , Estudos de Coortes , Humanos , Neoplasias/epidemiologia , Texas/epidemiologia , Trombose Venosa/epidemiologiaRESUMO
The lower extremities of 28 unselected children with congenital heart disease were investigated and classified according to the criteria for postthrombotic syndrome five to ten years after their first cardiac catheterization. For the clinical criteria, all patients completed a questionnaire and underwent a standardized physical examination of both legs. For the pathophysiologic criteria, the presence of venous outflow obstruction and reflux was evaluated by color duplex sonography in 24 of the 28 patients. Mild postthrombotic syndrome was present in half the patients. Partial or complete occlusion of the investigated vein was found in four patients (17%). In all patients studied, the venous valves of the deep system were competent. Postthrombotic syndrome frequently occurs in children with congenital heart disease. Prospective studies seem to be justified to investigate the precise incidence and potential risk factors.
Assuntos
Cardiopatias Congênitas/epidemiologia , Síndrome Pós-Flebítica/epidemiologia , Anticoagulantes/uso terapêutico , Cateterismo Cardíaco/efeitos adversos , Ponte Cardiopulmonar , Criança , Proteção da Criança , Pré-Escolar , Feminino , Veia Femoral/diagnóstico por imagem , Veia Femoral/patologia , Seguimentos , Cardiopatias Congênitas/terapia , Heparina/uso terapêutico , Humanos , Perna (Membro)/irrigação sanguínea , Perna (Membro)/diagnóstico por imagem , Perna (Membro)/cirurgia , Masculino , Países Baixos , Síndrome Pós-Flebítica/terapia , Fatores de Risco , Veia Safena/diagnóstico por imagem , Veia Safena/patologia , Falha de Tratamento , Ultrassonografia Doppler Dupla , Trombose Venosa/complicações , Trombose Venosa/terapiaRESUMO
We report 173 patients with venous thrombosis (or post-thrombotic syndrome) demonstrated by phlebography. We show up the importance of blood groups as risk factor, being very significant the A group. Female sex is associated with a high incidence of this pathology. A frequent location is the left lower limb.
Assuntos
Antígenos de Grupos Sanguíneos , Tromboflebite/sangue , Doença Aguda , Distribuição de Qui-Quadrado , Cuba/epidemiologia , Feminino , Humanos , Masculino , Síndrome Pós-Flebítica/sangue , Síndrome Pós-Flebítica/epidemiologia , Fatores de Risco , Fatores Sexuais , Tromboflebite/epidemiologiaRESUMO
40 limbs from normal persons and 32 limbs from patients with postphlebitic syndrome were studied. The latter group was classified according to the phlebography in partial and total recanalized postphlebitic groups. The research was carried out with a strain gauge plethysmograph and an ergometric bicycle. The patients showed the greater values of the venous volume, the maximal venous outflow and the rate of venous refilling, specially, the patients with total recanalized postphlebitic syndrome; this suggest a greater degree of venous valve insufficiency and a loss of the viscoelastic properties of venous vascular wall. The peripheral resistance was greater in the postphlebitic groups and it suggests a higher sympathetic nervous tone. The physical working capacity was lower in the postphlebitic patients and no relation was observed between it and the plethysmographic parameters.