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Hamostaseologie 1998; 18(01): 27-30
DOI: 10.1055/s-0038-1655325
Übersichtsarbeiten/Review Articles
Schattauer GmbH

Therapie der akuten tiefen Beinvenenthrombose mit niedermolekularen Heparinen

W.A. Wuillemin
1   Hämatologisches Zentrallabor der Universität Bern, Inselspital (Direktor/Chefarzt: Prof. Dr. med. B. Lämmle)
,
F. Demarmels Biasiutti
1   Hämatologisches Zentrallabor der Universität Bern, Inselspital (Direktor/Chefarzt: Prof. Dr. med. B. Lämmle)
,
B. Lämmle
1   Hämatologisches Zentrallabor der Universität Bern, Inselspital (Direktor/Chefarzt: Prof. Dr. med. B. Lämmle)
› Author Affiliations
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Publication History

Publication Date:
27 June 2018 (online)

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Zusammenfassung

Die akute tiefe Beinvenenthrombose ist eine häufige Erkrankung. Die klassische Behandlung besteht aus einer initialen Phase mit Heparin sowie einer Langzeittherapie mit oralen Antikoagulanzien. Die Therapie mit Heparin muß rasch begonnen werden, innerhalb von 24 Stunden im therapeutischen Bereich liegen und über 5 bis 7 Tage weitergeführt werden, bis die orale Antikoagulation ihrerseits im therapeutischen Bereich liegt. Zahlreiche Studien zeigten, daß die Therapie mit subkutan applizierten niedermolekularen Heparinen mindestens so wirksam und sicher ist wie die herkömmliche parenterale und labormäßig kontrollierte Gabe von unfraktioniertem Heparin. Die niedermolekularen Heparine haben jedoch den Vorteil der einfacheren Anwendung und der geringeren Rate von immunologisch-bedingter Thrombozytopenie. Sie stellen heute die Therapie der ersten Wahl dar bei der initialen Behandlung der akuten tiefen Beinvenenthrombose. Sie bieten außerdem die Möglichkeit der ambulanten bzw. der verkürzten stationären Therapie.

Eine Thrombolyse sollte nur in Ausnahmefällen durchgeführt werden, da sie mit einem höheren Blutungsrisiko verbunden ist und bezüglich klinisch relevanter Endpunkte der Therapie mit Heparinen nicht überlegen ist.

Schlüsselwörter

Tiefe Beinvenenthrombose - niedermolekulare Heparine - orale Antikoagulation - ambulante Therapie
 

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