{"id":991,"date":"2012-08-12T12:32:05","date_gmt":"2012-08-12T09:32:05","guid":{"rendered":"http:\/\/www.hvtd.org\/?p=991"},"modified":"2012-08-12T12:32:05","modified_gmt":"2012-08-12T09:32:05","slug":"derin-ven-trombozu-veya-ekonomi-sinifi-sendromu","status":"publish","type":"post","link":"https:\/\/www.hvtd.org\/?p=991","title":{"rendered":"Derin ven trombozu veya ekonomi s\u0131n\u0131f\u0131 sendromu"},"content":{"rendered":"

\"\"<\/a>Derin ven trombozu (dvt), toplardamarlardaki p\u0131ht\u0131n\u0131n neden oldu\u011fu damar t\u0131kanmas\u0131 hastal\u0131\u011f\u0131d\u0131r. U\u00e7ak yolculuklar\u0131n\u0131n dvt olu\u015fumunu kolayla\u015ft\u0131rd\u0131\u011f\u0131 60 y\u0131l kadar \u00f6nce fark edilmi\u015f, Ekonomi S\u0131n\u0131f\u0131 Sendromu terimi ise, 1977 y\u0131l\u0131nda Symington taraf\u0131ndan u\u00e7ak yolculu\u011fu sonras\u0131 geli\u015fen akci\u011fer embolisi olgular\u0131ndan esinlenerek yak\u0131\u015ft\u0131r\u0131lm\u0131\u015ft\u0131r.<\/p>\n

U\u00e7ak Yolculuklar\u0131nda Derin Ven Trombozu Olu\u015fumu<\/p>\n

Uzun u\u00e7u\u015flarda bacaklar\u0131n saatlerce belirli pozisyonda kas\u0131l\u0131 ve hareketsiz kalmas\u0131, kan dola\u015f\u0131m\u0131n\u0131 yava\u015flat\u0131r; \u00f6zellikle diz alt\u0131 (popliteal) toplardamar\u0131n\u0131n koltu\u011fun oturma par\u00e7as\u0131n\u0131n kenar\u0131 taraf\u0131ndan s\u0131k\u0131\u015ft\u0131r\u0131lmas\u0131, kan\u0131n damar i\u00e7indeki ak\u0131\u015f\u0131n\u0131 engeller. Burada olu\u015fan kan g\u00f6llenmesi, damar i\u00e7i bas\u0131nc\u0131n\u0131n artmas\u0131na ve damar i\u00e7 duvar\u0131nda minimal zedelenmelere yol a\u00e7ar. Ayr\u0131ca kan s\u0131v\u0131s\u0131n\u0131n bir k\u0131sm\u0131n\u0131n damar d\u0131\u015f\u0131na s\u0131zmas\u0131, damar i\u00e7indeki kan\u0131 yo\u011funla\u015ft\u0131r\u0131r. Sonu\u00e7ta kan\u0131n ak\u0131\u015f\u0131n\u0131n durmas\u0131, kan\u0131n yo\u011funla\u015fmas\u0131 ve damar i\u00e7 duvar\u0131ndaki zedelenmeler p\u0131ht\u0131 olu\u015fumunu kolayla\u015ft\u0131r\u0131r. P\u0131ht\u0131n\u0131n damar\u0131 t\u0131kayarak dola\u015f\u0131m bozuklu\u011fu yapmas\u0131ndan daha tehlikeli olan, buradan kopan p\u0131ht\u0131 par\u00e7alar\u0131n\u0131n ya\u015famsal organlarda damar t\u0131kanmalar\u0131na yol a\u00e7mas\u0131d\u0131r.<\/p>\n

Yolcu u\u00e7aklar\u0131n\u0131n ekonomi s\u0131n\u0131flar\u0131nda koltuk aralar\u0131 dar oldu\u011fu i\u00e7in, hem bacaklar\u0131 yeterince uzatma olana\u011f\u0131 yoktur, hem de \u00f6zellikle pencere taraf\u0131 yolcular\u0131n\u0131n koridora \u00e7\u0131kabilmeleri zahmetlidir. \u201cKoltu\u011fundan kalkmadan, saatlerce dizleri b\u00fck\u00fcl\u00fc ve ayn\u0131 pozisyonda oturan veya uyuyan\u201d ekonomi s\u0131n\u0131f\u0131 yolcular\u0131nda dvt riskinin artt\u0131\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclmektedir. Kabin g\u00f6revlileri s\u00fcrekli hareket halinde olduklar\u0131ndan riskleri \u00e7ok azd\u0131r; ancak kokpitte saatlerce oturarak g\u00f6rev yapan u\u00e7u\u015f ekibinin dvt riskleri daha fazlad\u0131r.<\/p>\n

Dvt olu\u015fumunu \u00f6zetleyen ana etkenler \u015funlard\u0131r :<\/p>\n

1. Damar i\u00e7i kan ak\u0131\u015f\u0131n\u0131n engellenmesi ve damar i\u00e7inde kan g\u00f6llenmesi,<\/p>\n

2. Toplardamar i\u00e7 duvar\u0131nda \u00f6nceden lezyon varl\u0131\u011f\u0131,<\/p>\n

3. Kan\u0131n p\u0131ht\u0131la\u015fma bozuklu\u011fu.<\/p>\n

Risk Fakt\u00f6rleri ve Dvt Klini\u011fi<\/p>\n

Kronik kalp-damar ve kanser hastal\u0131klar\u0131, p\u0131ht\u0131la\u015fma bozukluklar\u0131, \u015fi\u015fman ve uzun boylu olmak, sigara i\u00e7mek, gebelik, ya\u015fl\u0131l\u0131k, yorgunluk, \u00f6strojen ve do\u011fum kontrol ila\u00e7lar\u0131 kullanmak, fel\u00e7, ameliyat veya k\u0131r\u0131k al\u00e7\u0131s\u0131 nedeniyle uzun s\u00fcre hareketsiz yatmak, ba\u015fl\u0131ca risk fakt\u00f6rleridir. U\u00e7akta kabin i\u00e7i oksijen bas\u0131nc\u0131n\u0131n azl\u0131\u011f\u0131na ba\u011fl\u0131 olarak geli\u015fen hipoksi, akci\u011fer damarlar\u0131nda daralma yaparak emboliyi kolayla\u015ft\u0131rabilir. Dvt\u2019nin kad\u0131nlarda daha s\u0131k g\u00f6r\u00fcld\u00fc\u011f\u00fc, \u00f6zellikle menopoza girmi\u015f kad\u0131nlarda riskin erkeklere g\u00f6re 4 kat fazla bulundu\u011fu, bir \u00e7al\u0131\u015fmada olgular\u0131n %81\u2019inin kad\u0131n oldu\u011fu bildirilmektedir. Dvt olgular\u0131n\u0131n ya\u015f ortalamas\u0131 bir \u00e7al\u0131\u015fmada 58, di\u011ferinde 67 olarak verilmi\u015ftir.<\/p>\n

Damar i\u00e7i kan p\u0131ht\u0131la\u015fmalar\u0131n\u0131n %94\u2019\u00fc sessizdir; bir belirti vermeden s\u00fcre\u00e7 devam eder, p\u0131ht\u0131 ya damar yoluyla akci\u011fer, kalp veya beyin damarlar\u0131n\u0131 t\u0131kayarak bu organlarda enfarkt\u00fcs bi\u00e7iminde ya\u015famsal tehdit yarat\u0131r, veya yerinde kalarak aylar i\u00e7inde \u00e7\u00f6z\u00fcl\u00fcr. Bu s\u00fcre\u00e7te bacakla ilgili olarak d\u0131\u015ftan fark edilen belirtiler, \u015fi\u015fme, a\u011fr\u0131, uyu\u015fma ve renk de\u011fi\u015fimidir; nefes darl\u0131\u011f\u0131 ve g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 varsa akci\u011fer embolisi d\u00fc\u015f\u00fcn\u00fcl\u00fcr.<\/p>\n

Olgular\u0131n %20-25\u2019i ya uzun bir u\u00e7ak yolculu\u011fu s\u0131ras\u0131nda, ya hemen u\u00e7u\u015ftan sonraki saatlerde, veya 2 g\u00fcnden 1 aya kadar s\u00fcrelerde (ortalama 4 g\u00fcnde) belirti vermektedir. Akci\u011fer damarlar\u0131n\u0131n t\u0131kanmas\u0131 (emboli) en ciddi komplikasyondur.<\/p>\n

Derin Ven Trombozu \u0130nsidans\u0131<\/p>\n

Semptomatik yolcu trombozlar\u0131n\u0131n olu\u015f s\u0131kl\u0131\u011f\u0131 kesin olarak bilinmemekle birlikte \u0130ngiltere\u2019de y\u0131lda 30.000 vaka oldu\u011fu san\u0131lmaktad\u0131r. Y\u0131ll\u0131k insidans genel pop\u00fclasyonda 1\/1.000, u\u00e7ak yolcular\u0131nda 1\/27.000\u2019dir. Dvt olu\u015f oran\u0131 60 ya\u015f \u00fcst\u00fcnde binde 3-5, gen\u00e7-orta ya\u015flarda ise on binde birdir.<\/p>\n

\u00d6nlem ve \u00d6neriler<\/p>\n

Uzun u\u00e7u\u015flarda bir risk fakt\u00f6r\u00fc veya hastal\u0131k \u00f6yk\u00fcs\u00fc olsun-olmas\u0131n, t\u00fcm yolcular i\u00e7in \u00f6nerilen \u00f6nlemler \u015funlard\u0131r :<\/p>\n

1. Bagaj ve \u00e7antalar ayak alt\u0131na konmamal\u0131d\u0131r (bacak hareketlerini engellememek i\u00e7in)<\/p>\n

2. Bacaklara belirli aral\u0131klarla germe-uzatma-b\u00fckme hareketleri yapt\u0131r\u0131lmal\u0131, saatte bir 5 dakika gezinilmeli, derin nefes al\u0131nmal\u0131d\u0131r,<\/p>\n

3. Uzun s\u00fcre ayn\u0131 pozisyonda uyunmamal\u0131, yatma pozisyonu de\u011fi\u015ftirilmelidir (bacak damarlar\u0131n\u0131n s\u0131k\u0131\u015fmas\u0131n\u0131 \u00f6nlemek amac\u0131yla,)<\/p>\n

4. Uyku ilac\u0131 ve alkolden uzak durulmal\u0131d\u0131r (uyku ila\u00e7lar\u0131n\u0131n sa\u011flad\u0131\u011f\u0131 derin uyku nedeniyle yatma pozisyonu de\u011fi\u015ftirilemez, gezinilemez, bacak hareketleri azal\u0131r, damar s\u0131k\u0131\u015fmalar\u0131n\u0131n verdi\u011fi rahats\u0131zl\u0131k alg\u0131lanamaz\u2026 Alkol ise hem uyku ilac\u0131n\u0131n yaratt\u0131\u011f\u0131 olumsuzluklara, hem de idrar s\u00f6kt\u00fcrerek s\u0131v\u0131 kayb\u0131na neden oldu\u011fu i\u00e7in sak\u0131ncal\u0131d\u0131r,)<\/p>\n

5. U\u00e7u\u015f \u00f6ncesi ve u\u00e7u\u015f s\u0131ras\u0131nda susuzluk hissi olmasa bile s\u0131v\u0131 al\u0131m\u0131 artt\u0131r\u0131lmal\u0131d\u0131r (u\u00e7aktaki kabin havas\u0131 kuru oldu\u011fu i\u00e7in, ter ve nefes yoluyla s\u0131v\u0131 kayb\u0131 olur, s\u0131v\u0131 al\u0131m\u0131 da az ise, kan yo\u011funla\u015fmas\u0131 ve p\u0131ht\u0131la\u015fma olas\u0131l\u0131\u011f\u0131 artar),<\/p>\n

6. Hafif \u00f6dem ve damar \u015fi\u015fkinlikleri do\u011fald\u0131r; v\u00fccudu s\u0131kamayan rahat giysiler giyilmeli, rahats\u0131zl\u0131k veren durumlarda elastik bandaj veya varis \u00e7oraplar\u0131 kullan\u0131lmal\u0131d\u0131r, 50 ya\u015f \u00fcst\u00fcnde elastik \u00e7oraplar\u0131n \u00f6nemi daha fazlad\u0131r,<\/p>\n

7. Trombotik hastal\u0131klar, kanser olgular\u0131 ve yak\u0131nda ge\u00e7irilmi\u015f ameliyat gibi nedenlerle hareket k\u0131s\u0131tl\u0131l\u0131\u011f\u0131 olanlara cilt alt\u0131 heparin verilebilir, akci\u011fer embolisi riski olan ki\u015filer hekim kontrol\u00fcnde a\u011f\u0131zdan aspirin veya antikoag\u00fclan ila\u00e7lar alabilirler \u00f6nerilir,<\/p>\n

Hastal\u0131\u011f\u0131n as\u0131l ad\u0131 olan derin ven trombozu, u\u00e7ak yolculuklar\u0131nda s\u0131k g\u00f6r\u00fcld\u00fc\u011f\u00fc i\u00e7indir ki, \u201cekonomi s\u0131n\u0131f\u0131 sendromu\u201d ad\u0131yla pop\u00fcler olmu\u015ftur. Ancak bacaklarda kan g\u00f6llenmesine neden olan di\u011fer durumlarda da dvt olas\u0131d\u0131r. Yani u\u00e7akta ekonomi s\u0131n\u0131f\u0131nda oldu\u011fu kadar, l\u00fcks s\u0131n\u0131flarda da, otob\u00fcs, tren yolculuklar\u0131nda, uzun s\u00fcre ara\u00e7 kullanan s\u00fcr\u00fcc\u00fclerde, hatta ofis, k\u00fct\u00fcphane ve sinema gibi yerlerde uzun s\u00fcre hareketsiz ve kas\u0131l\u0131 oturanlar\u0131n bacaklar\u0131nda g\u00f6r\u00fclebilmektedir. Hatta dvt\u2019nin u\u00e7ak yolculuklar\u0131yla ba\u011flant\u0131s\u0131n\u0131n \u00e7ok zay\u0131f oldu\u011fu da ileri s\u00fcr\u00fclm\u00fc\u015ft\u00fcr. Son zamanlarda baz\u0131 yolcular ve sigorta \u015firketleri davalar a\u00e7arak, koltuk aralar\u0131n\u0131n ve koridorlar\u0131n geni\u015fletilmesiyle hastal\u0131\u011f\u0131n azalt\u0131labilece\u011fini \u00f6ne s\u00fcrmekte, havayolu \u015firketlerinin kazan\u00e7lar\u0131n\u0131n bir k\u0131sm\u0131ndan feragat ederek bu y\u00f6nde de\u011fi\u015fiklikler yapmalar\u0131n\u0131 istemektedirler.<\/p>\n

Yaz\u0131y\u0131 haz\u0131rlayan :<\/strong> Do\u00e7 Dr Muzaffer \u00c7eting\u00fc\u00e7<\/p>\n","protected":false},"excerpt":{"rendered":"

Derin ven trombozu (dvt), toplardamarlardaki p\u0131ht\u0131n\u0131n neden oldu\u011fu damar t\u0131kanmas\u0131 hastal\u0131\u011f\u0131d\u0131r. U\u00e7ak yolculuklar\u0131n\u0131n dvt olu\u015fumunu kolayla\u015ft\u0131rd\u0131\u011f\u0131 60 y\u0131l kadar \u00f6nce fark edilmi\u015f, Ekonomi S\u0131n\u0131f\u0131 Sendromu terimi ise, 1977 y\u0131l\u0131nda Symington taraf\u0131ndan u\u00e7ak yolculu\u011fu sonras\u0131 geli\u015fen akci\u011fer embolisi olgular\u0131ndan esinlenerek yak\u0131\u015ft\u0131r\u0131lm\u0131\u015ft\u0131r. U\u00e7ak Yolculuklar\u0131nda Derin Ven Trombozu Olu\u015fumu Uzun u\u00e7u\u015flarda bacaklar\u0131n saatlerce belirli pozisyonda kas\u0131l\u0131 ve hareketsiz kalmas\u0131, kan dola\u015f\u0131m\u0131n\u0131 yava\u015flat\u0131r; \u00f6zellikle […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[6],"tags":[],"class_list":["post-991","post","type-post","status-publish","format-standard","hentry","category-bulten"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/991","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=991"}],"version-history":[{"count":1,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/991\/revisions"}],"predecessor-version":[{"id":993,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/991\/revisions\/993"}],"wp:attachment":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=991"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=991"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=991"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}