Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492009000100011
Jornal Vascular Brasileiro
Review Article

Mobilização precoce na fase aguda da trombose venosa profunda de membros inferiores

Geane de Souza Penha; Ana Paula Damiano; Tales de Carvalho; Vinícius Lain; João Daniel Serafim

Downloads: 15
Views: 1527

Resumo

O tratamento convencional da trombose venosa profunda na fase aguda consiste em restrição ao leito. Porém, estudos recentes contestam essa abordagem terapêutica, enfatizando que a mobilização precoce propicia resultados clínicos favoráveis. O objetivo deste estudo foi pesquisar em literatura científica, principalmente ensaios clínicos controlados, sobre a mobilização precoce de pacientes portadores de trombose venosa profunda de membros inferiores na fase aguda. Utilizou-se como estratégia de pesquisa o site PubMed para a busca de estudos relacionados à mobilização precoce, deambulação e trombose venosa profunda na fase aguda. Os artigos consultados abrangeram o período de 1992 a 2007. Em todos os estudos, a mobilização precoce esteve associada à heparina de baixo peso molecular e a terapia de compressão. Estudos avaliados nesta revisão têm demonstrado os benefícios na redução da dor e edema, com melhora da qualidade de vida, pela estratégia terapêutica de mobilização precoce em combinação com anticoagulação e compressão da perna na trombose venosa profunda, sem que ocorra maior risco de desfechos relevantes, como embolia pulmonar e morte.

Palavras-chave

Trombose venosa, deambulação, compressão, extremidade inferior

References

Maffei FHA, Lastoria S, Yoshida WB, Rollo HA. Doenças vasculares periféricas. 2002;2.

Mello NA. Síndromes vasculares: clínica, diagnóstico, tratamento. 1999:383.

Verstraete M, Vermylen J. Trombose. 1989:356.

Labas P, Ohrádka B, Vladimír J, Cambal M. home treatment of deep vein thrombosis with low molecular weigth heparin, forced mobilisation and compression. Int Angiol. 2000;19:303-7.

Maffei FHA. Trombose venosa profunda dos membros inferiores: incidência, patologia, fisiopatologia e diagnóstico. Doenças vasculares periféricas. 2002:1363-86.

Fowkes FJ, Price JF, Fowkes FG. Incidence of diagnosed deep vein thrombosis in the general population: systematic review. Eur J Vasc Endovasc Surg. 2003;25:1-5.

Anderson FA, Wheeler HB, Goldberg RJ. A population based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism: the Worchester DVT Study. Arch Intern Med. 1991;151:933-8.

Prevention of venous thrombosis and pulmonary embolism. JAMA. 1986;256:744-9.

Diebold J, Löhrs U. Venous thrombosis and pulmonary embolism: A study of 5039 autopsies. Pathol Res Pract. 1991;187:260-6.

Saeger W, Genzkow M. Venous thrombosis and pulmonary embolisms in post-mortem series: probable causes by correlations of clinical data and basic diseases. Pathol Res Pract. 1994;190:394-9.

Lindblad B, Sternby NH, Berqqvist D. Incidence of venous thromboembolism verified by necropsy over 30 years. BMJ. 1991;302:709-11.

Aldrich D, Hunt DP. When can the patient with deep venous thrombosis begin to ambulate?. Phys Ther. 2004;84:268-73.

Aschwanden M, Labs KH, Engel H. Acute deep vein thrombosis: early mobilization does not increase the frequency of pulmonary embolism. Thromb Haemost. 2001;85:42-6.

Isma N, Johanssson E, Björk A. Does supervised exercise after deep venous thrombosis improve recanalization of occluded vein segments?: A randomized study. J Thromb Thrombolysis. 2007;23:25-30.

Partsch H, Oburger K, Mostbeck A, König B, Köhn H. Frequency of pulmonary embolism in ambulant patients with pelvic vein thrombosis: a prospective study. J Vasc Surg. 1992;16:715-22.

Partsch H, Blättler W. Compression and walking versus bed rest in the treatment of proximal deep venous thrombosis with low molecular weight heparin. J Vasc Surg. 2000;32:861-9.

Schellong SM, Schwarz T, Kropp J, Prescher Y, Beuthien-Baumann B, Daniel WG. Bed rest in deep venous thrombosis and the incidence of scintigraphic pulmonary embolism. Thromb Haemost. 1999;82(^s1):127-9.

Schaub RG, Simmons CA, Koets MH, Romano PJ 2nd, Stewart GJ. Early events in the formation of a venous thrombus following local trauma and stasis. Lab Invest. 1984;51:218-24.

Albuquerque HPC, Vidal PC. Trombose venosa profunda: revisão dos conceitos atuais. Rev Bras Ortop. 1996;31:851-6.

Sikorski JM, ampson WG, Stadsdon GE. The natural history and a etiology of deep vein thrombosis after total hip replacement. J Bone Joint Surg Br. 1981;63-B:171-7.

Thomas DP, Meston RE, Wood RD, Hockley DJ. The relationship between vesselwall injury and venous thrombosis: an experimental study. Br J Haematol. 1985;59:449-57.

Brenner BM, Troy JL, Ballerman BJ. Endothelium-dependent vascular responses. J Clin Invest. 1989;84:1373-8.

Hirsh J, Hull R. Venous thromboembolism: natural history, diagnosis and management. 1987:17-21.

Green D, Hirsh J, Heit J, Prins M, Davidson B, Lensing AW. Low molecular weight eparin: a critical analysis of clinical trials. Pharmacol Rev. 1994;46:89-10.

Merlo I, Parente JB, Komlós PP. Varizes e telangiectasias: diagnóstico e tratamento. 2006.

Figueiredo MAM, Filho AD, Cabral ALS. Avaliação do efeito da meia elástica na hemodinâmica venosa dos membros inferiores de pacientes com insuficiência venosa crônica. J Vasc Bras. 2004;3:231-7.

Blättler W, Partsch H. Leg compression and ambulation is better than bed rest for the treatment of acute deep venous thrombosis. Int Angiol. 2003.

Partsch H. Therapy of deep vein thrombosis with low molecular weight heparin, leg compression and immediate ambulation. Vasa. 2001;30:195-204.

Kiser TS, Stefans VA. Pulmonary embolism in rehabilitation patients: relation to time before return to physical therapy after diagnosis of deep vein thrombosis. Arch Phys Me Rehabil. 1997;78:942-5.

Partsch H, Kaulich M, Mayer W. Immediate mobilisation in acute vein thrombosis reduces post-thrombotic syndrome. Int Angiol. 2004;23:206-12.

Partsch H. Ambulation and compression after deep vein thrombosis: dispelling myths. Semin Vasc Surg. 2005;18:148-52.

Jünger M, Diehm C, Störiko H. Mobilization versus immobilization in the treatment of acute proximal deep venous thrombosis: a prospective, randomized, open,multicentre trial. Curr Med Res Opin. 2006;22:593-602.

Samama MM, Simonneau G, Wainstein J-P, De Vathaire F, Huet Y, Landauer D. SIRIUS Study: Epidemiology of risk factors of deep venous thrombosis of the lower limbs in community practice. Thromb Haemost. 1993;69:797A.

Killewich LA, Macko RF, Cox K. Regression of proximal deep venous thrombosis is associated with fibrinolytic enhancement. J Vasc Surg. 1997;26:861-8.

Fischer H. Eine neue Therapie der Phlebitis. Med Klin. 1910;30:1172-80.

Partsch H, Menzinger G, Mostbeck A. Inelastic leg compression is more effective to reduce deep venous refluxes than elastic bandages. Dermatol Surg. 1999;25.

Schulman S. Studies on the medical treatment of deep vein thrombosis. Acta Med Scand. 1985;704:1-68.

Qvarfordt P, Christenson JT, Eköf B, Ohlin P, Saltin B. Intramuscular pressure,muscle blood flow, and skeletalmuscle metabolism in chronic anterior tibial compartment syndrome. Clin Orthop Relat Res. 1983;179:284-90.

Susan RK, Jeffrey SG. Arch Intern Med. 2004;164(^s17-26).

Stick C, Grau H, Witzleb E. On the edema: preventing effect of the calf muscle pump. Eur J Appl Physiol. 1989;59:39-47.

Padberg FT Jr, Johnson MV, Sisto SA. Structured exercise improves calf muscle pump function in choronic venous insufficiency: a randomized trial. J Vasc Surg. 2004;39:79-87.

Journal of Vascular Surgery. .

Shrier I, Kahn SR. Effect of physical activity after recent deep venous thrombosis: a cohort study. Med Sci Sports Exerc. 2005;37:630-4.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddfdabb0e8825062b4ce1d5 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections