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Djup ventrombos, DVT

Senast uppdaterad: Senast reviderad:
Sakkunnig:
Definition:
Trombosbildning i de stora, djupt liggande venerna i vader, lår, bäcken eller arm-/skulderregionen.
Förekomst:
Den åldersjusterade incidensen är omkring 130/100 000/år för män och 110/100 000/år för kvinnor.
Symtom:
Typiska inflammationstecken som smärta, värme, rodnad, svullnad och nedsatt funktion – men symtomen finns inte alltid. Patienten klagar ofta över ömhet eller smärta när han/hon står eller går. Vanligtvis lindras smärtan av vila med det påverkade benet i högläge.
Kliniska fynd:
Ensidigt ödem i vaden, rodnad och temperaturökning på den påverkade sidan. Venstas/prominenta ytliga vener. Ömhet vid palpation.
Diagnostik:
Wells score och D-dimer är till hjälp för att bedöma sannolikhet för DVT i primärvård. Diagnosen ställs genom bilddiagnostisk undersökning, i första hand ultraljud.
Behandling:
Avlastning innan säker diagnos, tidig mobilisering, kompression och antikoagulationsbehandling. NOAK är förstahandsval som sekundärprofylax.
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  • Peter J Svensson, professor och överläkare, Koagulationscentrum, Skånes universitetssjukhus
  • Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet