Perbandingan Pemberian Heparin Subkutan dan Intravena terhadap Studi Koagulasi dan D-Dimer Pasien dengan Risiko Trombosis Vena
Latar Belakang :Trombosis di Amerika Serikat adalah penyebab kematian terbanyak. Sekitar 2 juta orang meninggal setiap tahun karena trombosis arteri dan vena. Dengan 80-90% thrombosis diketahui penyebabnya. Trombosis juga menyebabkan morbiditas yang signifikan, salah satunya adalah trombosis vena dalam (Deep Vein Thrombosis, DVT) yang dapat berlanjut menjadi emboli paru. Tanpa tromboprofilaksis, kejadian DVT nosokomial adalah 10-40% dari keseluruhan pasien medis dan bedah dan 40-60% pada pasien pasca bedah ortopedi mayor.
Tujuan: Untuk membandingkan efektivitas dosis profilaksis heparin subkutan dan intravena terhadap nilai D-Dimer, PPT dan aPTT pada pasien dengan risiko trombosis vena dalam.
Metode: Penelitian ini menggunakan desain kelompok pre dan post test dan dilakukan pada 20 pasien dengan risiko trombosis vena dalam. Sampel darah diambil setelah 1 jam injeksi heparin, kemudian disimpan dalam botol yang mengandung EDTA. Sampel dikirim ke laboratorium untuk pemeriksaan. Subyek dibagi menjadi dua kelompok secara random sampling. Grup A menerima heparin intravena dan kelompok B menerima heparin subkutan. Analisis statistik dilakukan untuk menguji perbedaan antar kelompok dengan SPSS versi 15.
Hasil: Hasil pemeriksaan aPTT dan PPT antara kelompok intravena dan subkutan tidak menunjukkan perbedaan yang signifikan (p> 0,05). Hasil pengujian pada D-Dimer intravena dan subkutan juga tidak menunjukkan perbedaan yang signifikan (p> 0,05).
Kesimpulan: Tidak ada perbedaan yang signifikan antara pemberian heparin intravena dan subkutan dalam nilai aPTT, PPT dan D-Dimer sebagai pencegahan risiko thrombosis vena dalam.
Article Metrics:
- Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004 (Sep);126(3 Suppl):338S–400S
- Geerts WH, Heit JA, Clagett GP, Pineo GF, Colwell CW, Anderson Jr FA, et al. Prevention of venous thromboembolism. Chest 2001 (Jan);119(1Suppl):132S–75S
- Heit JA, Silverstein MD, Mohr DN, Petterson TM, O'Fallon WM, Melton III LJ. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med 2000 (Mar 27);160(6):809–15
- Levitan N, Dowlati A, Remick SC, Tahsildar HI, Sivinski LD, Beyth R, et al. Rates of initial and recurrent thromboembolic disease among patients with malignancy versus those without malignancy. Risk analysis using Medicare claims data. Medicine (Baltimore) 1999 (Sep);78(5):285–91
- Morgan MA, Iyengar TD, Napiorkowski BE, Rubin SC, Mikuta JJ. The clinical course of deep vein thrombosis in patients with gynecologic cancer. Gynecol Oncol 2002 (Jan);84(1):67–71
- Elizabeth M. Van Cott, M.D., and Michael Laposata, M.D., Ph.D., Coagulation. In: Jacobs DS et al, ed. The Laboratory Test Handbook, 5th Edition. Lexi-Comp, Cleveland, 2001; 327-358
- Gottfried EL and Adachi MM, Prothrombin Time and Activated Partial Thromboplastin Time Can Be Performed on the First Tube,Am J Clin Pathol, 1997, 107(6):681-3
- Andrew M, Paes B, and Johnston M, Development of the Hemostatic System in the Neonate and Young Infant,Am J Pediatr Hematol Oncol, 1990, 12(1)95-104
- Burns ER, Goldberg SN, and Wenz B, Paradoxic Effect of Multiple Mild Coagulation Factor Deficiencies on the Prothrombin Time and Activated Partial Thromboplastin Time,.Am J Clin Pathol, 1993, 100(2):94-8
- Prandoni P, Bagatella P, Bernardi E, et al, Use of an Algorithm for Administering Subcutaneous Heparin in the Treatment of Deep Venous Thrombosis,Ann Intern Med, 1998, 129(4):299-302
- Kearon C, Harrison L, Crowther M, et al, Optimal Dosing of Subcutaneous Unfractionated Heparin for the Treatment of Deep Vein Thrombosis,Thromb Res, 2000, 97(6):395-403
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