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Hamostaseologie 1996; 16(04): 220-226
DOI: 10.1055/s-0038-1656661
Übersichtsarbeiten/Review Articles
Schattauer GmbH

Reokklusionsprophylaxe im Kindesalter

Sabine Becker
1   Klinikum der Johann-Wolfgang-Goethe-Universität, Zentrum der Kinderheilkunde und Jugendmedizin, Klinik für Kinderheilkunde III - Pädiatrische Hämatologie und Onkologie (Leiter: Prof. B. Kornhuber), Frankfurt a. M.
,
Christine Heller
1   Klinikum der Johann-Wolfgang-Goethe-Universität, Zentrum der Kinderheilkunde und Jugendmedizin, Klinik für Kinderheilkunde III - Pädiatrische Hämatologie und Onkologie (Leiter: Prof. B. Kornhuber), Frankfurt a. M.
,
Elisabeth Lenz
2   Universitätskinderklinik Göttingen
,
W. Kreuz
1   Klinikum der Johann-Wolfgang-Goethe-Universität, Zentrum der Kinderheilkunde und Jugendmedizin, Klinik für Kinderheilkunde III - Pädiatrische Hämatologie und Onkologie (Leiter: Prof. B. Kornhuber), Frankfurt a. M.
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Publication History

Publication Date:
24 July 2018 (online)

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Zuammenfassung

Für eine erfolgreiche Lysetherapie bei venösen und arteriellen thrombotischen Verschlüssen ist eine Reokklusionsprophylaxe essentiell. Dabei ist ein möglichst frühzeitiger Beginn - parallel zur Lysetherapie - wichtig. Als Adjuvans zu den Fibrinolytika werden bei Erwachsenen neben unfraktioniertem Heparin auch niedermolekulare Heparine (LMWH) eingesetzt; letztere scheinen zumindest gleich wirksam bei etwas geringerem Blutungs- und Nebenwirkungsrisiko. Nach venösen Thrombosen im Kindesalter werden zur Langzeitprophylaxe Cumarinderivate eingesetzt. Bei Kontraindikationen für Cumarin könnten sich niedermolekulare Heparine (LMWH) in Zukunft als vielversprechende Alterna-tiven auch für pädiatrische Patienten erweisen. Allerdings gibt es noch keine Daten zum Osteoporoserisiko unter Langzeitgabe von LMWH; speziell im Kindesalter sollten Nutzen und Risiken für diese Substanzen sorgfältig abgewogen werden. Die Reokklusionsprophylaxe arterieller Gefäße stellt eine Indikation in erster Linie für Azetylsalizylsäure neben unfraktioniertem Heparin und LMWH dar. Im Gegensatz zum Erwachsenenalter werden bei Kindern alle Dosierungen an das Körpergewicht oder die Körperoberfläche angepaßt.

Schlüsselwörter

Thrombose - Reokklusion - Prophylaxe - Kinder
 

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