PERBANDINGAN PEMBERIAN HEPARIN INTRAVENA DAN SUBKUTAN TERHADAP KADAR PPT DAN PTTK PADA PENCEGAHAN DEEP VEIN THROMBOSIS

Abstract

Background: Thrombosis in the United States is the leading cause of death. About 2 million people die every year either because of an artery or vein thrombosis. In Indonesia, the incidence of diseases caused by thrombosis, such as stroke and heart attack, have the highest mortality rate. Morbidity of this disease is also quite high, one of them is Deep Vein Thrombosis (DVT) which can be a complicated to pulmonary embolism. Prophylaxis for DVT is relatively easy, by using the anticoagulant heparin. However, control of the dose of heparin must also be considered because it can cause bleeding if the dose is too high. One way to monitor the heparin was to assess the Plasma Prothrombin Time (PPT) and Partial Thromboplastin Time with Kaolin (PTTK). Objectives: To determine the effect of intravenous and subcutaneous heparin distribution on the value of PPT and PTTK towards DVT prevention. Methods: This design was observational - analytic with a cross sectional design by collecting data from the medical records in dr. Kariadi central hospital Semarang. 20 patients who has fulfill the inclusion and exclusion criteria, which the data taken was PPT and PTTK levels among ICU / HCU patients who has given the anticoagulant heparin in intravenously or subcutaneously. Data described in the table and performed by chi-square, Wilcoxon and Mann-whitney tests with SPSS for Windows 17.0. Results: There is no significant difference (p = 0.386) between the value of the PPT before and after distribution of intravenous heparin (15.580  4.405seconds vs 14,210  3,627 seconds). While, the distribution of subcutaneous heparin found no significant difference (p = 0.553) in the PPT between before and after distribution of heparin (14.680  2.907 seconds vs. 13.690  2.978 seconds). And there were no significant differences (p = 0.646) between the PTTK before and after intravenous heparin (43.490 40.803 seconds vs. 41.480 30.030 seconds). While the value of PTTK to the subcutaneous heparin given between before and after administration of heparin (31.110  11.157 seconds vs. 43.040 20.008 seconds) found no significant difference (p = 0.203) After the difference in PPT values between intravenous and subcutaneous administration of heparin, found no significant difference (p = 0.832). And the difference on the PTTK between intravenous and subcutaneous administration of heparin found no significant difference (p = 0.597) Conclusion: There was no significant difference in the value of PPT and PTTK between the distribution of intravenous and subcutaneous heparin in the prevention of deep vein thrombosis. Key words: DVT, PPT, PTTK, anticoagulant heparin.