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Seguridad y eficacia de la tromboprofilaxis farmacológica después de una nefrolíto- tomía percutánea: un estudio de

Behnam Shakiba1, Nasim Torabi2, Robab Maghsoudi1

  • 1Department of Urology, School of Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.

World journal of urology
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Resumen
Este resumen es generado por máquina.

La heparina no fraccionada después de la nefrolítopsia percutánea (PCNL) parece segura para prevenir el tromboembolismo venoso (TEV) en pacientes de alto riesgo. Aunque no se ha demostrado definitivamente, la heparina puede reducir los eventos de TEV sin aumentar las complicaciones hemorrágicas.

Palabras clave:
Heparina y sus derivadosNefrolitotomíaPercutáneoFarmacologíaSeguridad y seguridad

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Área de la Ciencia:

  • Nefrología
  • Cirugía vascular
  • Farmacología

Sus antecedentes:

  • La nefrolitotomía percutánea (PCNL) es un procedimiento estándar para cálculos renales grandes, pero conlleva riesgos de sangrado y tromboembolismo venoso (TEV).
  • Las directrices actuales no recomiendan rutinariamente la tromboprofilaxis farmacológica debido a la preocupación por la hemorragia y la evidencia limitada.
  • Este estudio investiga la heparina no fraccionada para la profilaxis de TEV en pacientes con NLP de riesgo moderado a alto.

Objetivo del estudio:

  • Evaluar la seguridad y eficacia de la heparina no fraccionada para la profilaxis de TEV en pacientes sometidos a NLP.
  • Comparar las complicaciones hemorrágicas y los eventos tromboembólicos entre los pacientes tratados con heparina y los tratados con ambulación precoz.

Principales métodos:

  • Un estudio de cohorte retrospectivo de 202 pacientes sometidos a NLP.
  • Los pacientes se dividieron en dos grupos: profilaxis con heparina no fraccionada (n=79) y ambulación temprana sin profilaxis farmacológica (n=123).
  • Se compararon los resultados, incluidos hemorragias, transfusiones, complicaciones y eventos tromboembólicos.

Principales resultados:

  • Los pacientes que recibieron heparina eran mayores y tenían un IMC más alto.
  • No se encontraron diferencias significativas en el tamaño de las piedras, la duración de la cirugía, la disminución de la hemoglobina, las tasas de transfusión o las complicaciones generales.
  • Los acontecimientos tromboembólicos fueron raros y no fueron significativamente diferentes entre los grupos; sin embargo, el grupo de ambulación temprana tuvo tres acontecimientos de TEV, incluyendo una fatalidad.

Conclusiones:

  • La tromboprofilaxis con heparina no fraccionada después de PCNL parece segura, sin aumento del riesgo de hemorragia.
  • Los hallazgos sugieren un beneficio potencial en la reducción de eventos tromboembólicos en pacientes de riesgo moderado a alto.
  • Las conclusiones definitivas están limitadas por el diseño retrospectivo y el tamaño de la muestra.