Deep Vein Thrombosis and Pulmonary Embolism Korean 환자교육 혈액항응고과 심정맥혈전증과폐색전증원인, 위험성, 그리고치료 이인쇄물은심정맥혈전증 (DVT) 과폐색전증 (PE) 의원인, 증상, 위험성그리고치료에관하여설명합니다. 심정맥혈전증이무엇입니까? (DVT) 은팔이나다리에있는정맥에혈액응고 ( 혈전 ) 가생기는것입니다. 이것은즉시치료받아야합니다. 이치료는, 병원에꼭입원하시지않고통원하면서나때로는집에서받을수있습니다. 심정맥혈전증의원인은무엇입니까? 심정맥혈전증은부상이나수술이나장기간의침대에서의요양이후, 또는장거리자동차나비행기로여행했을때발생할수있습니다. 어떤경우에는심정맥혈전증이아무런이유없이생기거나혈액응고의위험성을증가시키는내재하고있는질병으로부터발생합니다. 심정맥혈전증의증상은어떤것들입니까? 염증 혈전 정맥 가장흔한심정맥혈전증상들은 : 부기 DVT 는흔히다리나사타구니에있는 혈관에형성됩니다. 통증또는민감함 붉은기또는변색
Page 2 혈액항응고과심정맥혈전증과폐색전증 DVT 와 PE 는즉시피를묽게하는약물치료가필요합니다. 이러한약들은각별한관찰이필요합니다. 폐색전증은무엇입니까? 정맥안에혈액응고는폐를포함한신체의다른부분으로이동할수있습니다. 폐에혈액응고가있는것을폐색전증 (PE) 이라고불립니다. 이같은종류의혈액응고는생명을위협할수있습니다. 이것은즉시치료를받아야합니다. PE 의증상은어떤것들입니까? PE 의증상들은다음과같습니다 : 가슴통증 빠른심장박동 숨가쁨 기침 열 어떻게 DVT 를치료합니까? DVT 는피를묽게하는약제 ( 혈액항응고제 ) 로치료합니다. 환자분은처음 5 일내지 7 일동안, 급속히작용하는약인에녹사파린 ( 로브녹스 ) 를받으실것입니다. 이약은 피부밑 ( 피하조직 ) 에주사합니다. 환자분은자신이직접주사를놓는것을배우거나, 아니면가족이나친구가환자분에게주사를놓는것을배울수있습니다. 환자분은또한경구용혈액항응고제인와파린 ( 쿠마딘 ) 의복용을시작할것입니다. 와파린은효력이생길때까지몇일걸립니다. 두가지약을복용하기시작한지 5 일에서 7 일이지난후, 에녹사파린은중단될 것입니다. 와파린치료법은삼개월에서육개월동안지속될수도있습니다. 어떤 경우에는와파린치료법이육개월보다더오래걸릴수도있습니다. 혈액항응고제의부작용은어떤것들이있습니까? 혈액항응고제들은부작용을일으킬수있습니다. 출혈이가장흔한문제입니다. 에녹사파린과와파린은두가지다출혈을피하기위해서조심스러운사용과관찰을 필요로합니다. 앞으로몇일동안에녹사파린과와파린에대한사용, 관찰, 그리고, 가능한부작용에 대해서더많이배울것입니다. 환자분은더많이알수있도록더많은인쇄물과단독 강의를받게될것입니다. 지시사항 각단계를끝냈을때표시해주십시오 : 1. 에녹사파린연습용세트를받음. 2. 에녹사파린 ( 세트에들어있음 ) 과와파린 ( 직원에게서받음 ) 에관한책자를읽음. 3. 자신이직접피하주사로에녹사파린을놓는방법을배움.
Page 3 항응고클리닉심정맥혈전증과폐색전증 질문있으십니까? 환자분의질문은 중요합니다. 만일 질문이나걱정되는점이 있으시면담당의사 선생님이나건강 관리인에게 전화하십시오. UWMC 혈액항응고과 : SCCA 혈액항응고과 : 206-288-6756 Harborview Medical Center 혈액항응고과 : 206-744-2976 UWMC Anticoagulation Clinic Box 356015 1959 NE Pacific St. Seattle, WA 98195 4. 에녹사파린과와파린을약국에서구입함. 5. 처방대로정확히약을복용함. 6. 혈액항응고관리를위해서 ( 날 ) ( 시 ) 에 ( 장소 ) 로다시방문함. 7. 담당의사선생님을보기위하여 ( 날 ) ( 시 ) 에 ( 장소 ) 로다시방문함. 8. 차후검사를받기위하여 ( 날 ) ( 시 ) 에. 혈관검사실로다시방문함. 의사선생님께전화해야할때 만일다음과같은증상이있으면담당의사선생님 ( 이름 ) 에게 ( 전화번호 ) 로즉시전화하십시오 : 넘어지거나머리를부딪침. DVT 로인해서다리나팔에다음의증상이가중되면 : - 부기 - 통증 - 민감성 - 붉거나변색 아래와같은증상이있으면 : - 가슴통증 - 빠른심장박동 - 숨이가쁨 - 기침 - 열 - 피가기침할때나오거나튀거나아니면토해짐 - 소변에피가비침 ( 분홍색소변 ) - 대변에피가섞여나옴 ( 선명하게붉거나, 또는까맣고끈적한대변 ) - 이유없이특이하게멍이들거나출혈 - 베이거나상처난곳의출혈 - 코피 - 에녹사파린주사를맞은부위의출혈 만일담당의료관리인에게연락이않되면, 가장가까이있는응급치료실로가셔서혈전증이있다고설명하십시오. University of Washington Medical Center Deep Vein Thrombosis and Pulmonary Embolism Korean 01/2000 Rev. 01/2010 Translation by UWMC Interpreter Services Reprints on Health Online: http://healthonline.washington.edu
Patient Education Anticoagulation Clinic Deep Vein Thrombosis and Pulmonary Embolism Causes, risks, and treatment This handout explains the causes, symptoms, risks, and treatment for deep vein thrombosis (DVT) and pulmonary embolism (PE). What is a deep vein thrombosis? A deep vein thrombosis (DVT) is a blood clot (thrombus) in one of the veins in your leg or arm. It must be treated right away. This treatment can be given in the hospital, or sometimes at home, so that you do not have to be admitted to the hospital. What causes a DVT? DVTs can occur after an injury, after surgery, or after prolonged bed rest or long trips in a car or plane. In some cases, DVTs occur without any apparent cause, or from underlying diseases that increase the risk of blood clotting. What are the symptoms of DVT? The most common symptoms of DVT are: Swelling Pain or tenderness Redness or discoloration DVTs most often occur in leg or groin blood vessels.
Page 2 Anticoagulation Clinic Deep Vein Thrombosis and Pulmonary Embolism DVT and PE require treatment right away with blood thinning medicines. These medicines require special monitoring. What is a pulmonary embolism? Clots that form in veins can travel to other parts of the body, including the lungs. A blood clot in the lungs is called a pulmonary embolism (PE). This type of clot can be life-threatening. It must be treated right away. What are the symptoms of PE? Symptoms of PE include: Chest pain Rapid heart beat Shortness of breath Cough Fever How is DVT treated? DVT is treated with blood-thinning medicines (anticoagulants). For the first 5 to 7 days, you will receive enoxaparin (Lovenox), a drug that works quickly. This medicine is injected under the skin (subcutaneous). You will learn to give yourself these injections, or a family member or friend can learn to give them to you. You will also begin to take warfarin (Coumadin), an anticoagulant that is taken by mouth. Warfarin takes a few days to take effect. After 5 to 7 days of taking both medicines, enoxaparin will be stopped. Warfarin therapy may continue for about 3 to 6 months. At times, warfarin is taken longer than 6 months. What are the side effects of blood thinners? Anticoagulants can cause side effects. Bleeding is the most common problem. Both enoxaparin and warfarin require careful use and monitoring to avoid bleeding. Over the next few days, you will learn much more about the use, monitoring, and possible side effects of enoxaparin and warfarin. You will get more handouts and one-on-one teaching to help you learn more. Your Instructions Check off each step when done: 1. Receive an enoxaparin teaching kit. 2. Read the booklets about enoxaparin (in the kit) and warfarin (given to you by a staff person). 3. Learn to give yourself enoxaparin by subcutaneous injection. 4. Fill your prescriptions for enoxaparin and warfarin.
Anticoagulation Clinic Deep Vein Thrombosis and Pulmonary Embolism Questions? Your questions are important. Call your doctor or health care provider if you have questions or concerns. Anticoagulation Clinics: University of Washington Medical Center: Seattle Cancer Care Alliance: 206-288-6756 Harborview Medical Center: 206-744-2976 5. Take your medicines exactly as told. 6. Return to (location) for anticoagulation management on (date) at (time). 7. Return to (location) to see your care provider on (date) at (time). 8. Return to the Vascular Lab for a follow-up exam on (date) at (time). When to Call the Doctor Call your care provider (name) right away, at (phone number) if you: Fall or hit your head. Have an increase in these symptoms in the leg or arm with the DVT: - Swelling - Pain - Tenderness - Redness or discoloration Have these symptoms: - Chest pain - Rapid heartbeat - Shortness of breath - Cough - Fever - Coughing up, spitting up, or throwing up blood - Blood in your urine (urine is pink) - Blood in your stool (stool is bright red, or dark and tarry) - Unusual bruising or bleeding for unknown reasons - Bleeding from cuts or wounds - Bleeding from your nose - Bleeding at sites where enoxaparin has been injected If you can t reach your care provider, go to the nearest emergency room and explain that you have a blood clot. UWMC Anticoagulation Clinic Box 356015 1959 NE Pacific St. Seattle, WA 98195 Seattle Cancer Care Alliance is a collaboration of Fred Hutchinson Cancer Research Center, UW Medicine, and Seattle Children s University of Washington Medical Center 01/2000 Rev. 01/2010 Reprints on Health Online: http://healthonline.washington.edu