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Profilaxia para tromboembolismo venoso

Последний просмотренный: 18 Jun 2025
Last updated: 28 Oct 2024

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • tromboembolismo venoso prévio, trombofilia, malignidade, quadro pós-operatório, trauma e cateter de demora central
  • afecções clínicas crônicas, paresia, idade avançada, obesidade, pílulas contraceptivas contendo estrogênio e terapia de reposição hormonal, veias varicosas, gravidez e pós-parto de até 6 semanas, parente de primeiro grau com história de tromboembolismo venoso, viagens prolongadas e internação em unidade de terapia intensiva
Полная информация

Факторы риска

  • tromboembolismo venoso prévio (trombose venosa profunda (TVP) e/ou embolia pulmonar (EP))
  • trombofilia
  • neoplasia maligna
  • quadro pós-operatório
  • trauma
  • cateter de demora central (membro superior ou inferior)
  • imobilidade
  • doenças mieloproliferativas
  • insuficiência cardíaca congestiva
  • doença pulmonar obstrutiva crônica
  • doença inflamatória intestinal (DII)
  • doença neurológica com paresia de membro
  • idade mais avançada
  • obesidade
  • pílulas anticoncepcionais contendo estrogênio, terapia de reposição hormonal (TRH) e terapia de privação androgênica
  • história de veias varicosas
  • gestação/pós-parto
  • viagens longas
  • imobilidade da perna
  • parente de primeiro grau com história de tromboembolismo venoso
  • internação em unidade de terapia intensiva
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • Hemograma completo
  • creatinina sérica
  • razão normalizada internacional (INR)
  • tempo de tromboplastina parcial (TTP)
Полная информация

Исследования, проведение которых нужно рассмотреть

  • anticorpos anti-fator 4 plaquetário séricos
Полная информация

Алгоритм лечения

Начальные

todos os pacientes com risco

Острый

pacientes com trauma

pacientes cirúrgicos

pacientes com afecções não cirúrgicas

Составители

Авторы

Anna L. Parks, MD

Assistant Professor

Division of Hematology

University of Utah

Salt Lake City

UT

Раскрытие информации

ALP declares that she has no competing interests.

Выражение благодарностей

Dr Anna L. Parks would like to gratefully acknowledge Dr Nathalie Routhier, Dr Vicky Tagalakis, Dr Farah Zarka, Dr Vincent Bouchard-Dechêne, and Dr Adi J. Klil-Drori, previous contributors to this topic.

Раскрытие информации

NR, FZ, VBD, and AJKD declare no competing interests. VT has received honoraria from BMS Pfizer and Bayer. She has developed educational materials for Thrombosis Canada. VT is an author of references cited in this topic.

Рецензенты

Andrew Parfitt, MBBS, FFAEM

Clinical Director

Acute Medicine

Associate Medical Director

Consultant Emergency Medicine

Guy's and St Thomas' NHS Foundation Trust

Clinical Lead and Consultant

Accident Emergency Medicine

St Thomas' Hospital

London

UK

Раскрытие информации

AP declares that he has no competing interests.

Sudeep Shivakumar, MD

Hematologist

Thrombosis Fellow

University of Ottawa

Ottawa Health Research Institute

Ottawa

Canada

Disclosures

SS declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Gould MK, Garcia DA, Wren SM, et al. Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012 Feb;141(suppl 2):e227S-77S.Full text  Abstract

Falck-Ytter Y, Francis CW, Johanson NA, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012 Feb;141(2 Suppl):e278S-325.Full text  Abstract

Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012 Feb;141 (2 Suppl):e195S-226S.Full text  Abstract

National Institute for Health and Care Excellence. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism. Aug 2019 [internet publication].Full text

Nicolaides AN, Fareed J, Spyropoulos AC, et al. Prevention and management of venous thromboembolism. International consensus statement (guidelines according to scientific evidence). Int Angiol. 2024 Feb;43(1):1-222.Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Guidelines

    • NCCN clinical practice guidelines in oncology: cancer-associated venous thromboembolic disease
    • Clinical practice guidelines for the reduction of venous thromboembolic disease in colorectal surgery
    More Guidelines
  • Patient information

    Trombose venosa profunda (TVP) e viagem recente de longa distância

    Trombose venosa profunda

    More Patient information
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