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01-10-2007 | Artikelen

Veneuze trombo-embolie bij kinderen: diagnostiek, preventie en behandeling

Auteurs: Mw. dr. C. H. van Ommen, F. Smiers, I. Appel

Gepubliceerd in: Tijdschrift voor Kindergeneeskunde | Uitgave 5/2007

Samenvatting

Door een toenemende incidentie van veneuze trombo-embolie als complicatie van een centrale veneuze katheter of chronische ziekte, worden steeds meer kinderen preventief of therapeutisch behandeld met antistollingsmiddelen. Specifieke richtlijnen voor kinderen zijn van groot belang. In de nieuwe (concept) cbo-richtlijn ‘Diagnostiek, preventie en behandeling van veneuze tromboembolie en secundaire preventie arteriële trombose’ wordt ook aandacht aan kinderen besteed. De klinische diagnose veneuze trombose in de bovenste lichaamshelft wordt radiologisch bevestigd met echodoppler en/of flebografie. Longembolie kan gediagnosticeerd worden met ventilatie-perfusiescintigrafie of multidetector computertomografie. Trombose van de onderste ledematen wordt vastgesteld met echodoppler. Primaire tromboseprofylaxe wordt bij kinderen met een centrale veneuze katheter niet geadviseerd. Tromboseprofylaxe kan wel overwogen worden bij kinderen met een katheter, die eerder kathetertrombose hebben doorgemaakt, en bij kinderen met thuisbehandeling met totale parenterale voeding. De antistollingsbehandeling bestaat initieel uit laag-moleculair-gewicht of ongefractioneerde heparine, gevolgd door vitamine K-antagonisten of laag-moleculair-gewicht heparine. De duur van de behandeling is minimaal drie maanden, afhankelijk van het risicoprofiel van de patiënt. Na diepe veneuze trombose van het been wordt geadviseerd om gedurende twee jaar therapeutische elastische kousen te dragen om posttrombotische klachten te voorkomen.

vorige artikel Diagnostiek en behandeling van de ziekte van Von Willebrand

volgende artikel De effectiviteit van de behandeling van diffuse intravasale stolling bij kinderen; een systematische review

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Titel: Veneuze trombo-embolie bij kinderen: diagnostiek, preventie en behandeling
Auteurs: Mw. dr. C. H. van Ommen
F. Smiers
I. Appel
Publicatiedatum: 01-10-2007
Uitgeverij: Bohn Stafleu van Loghum
Gepubliceerd in: Tijdschrift voor Kindergeneeskunde / Uitgave 5/2007
Print ISSN: 0376-7442
Elektronisch ISSN: 1875-6840
DOI: https://doi.org/10.1007/BF03061696

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