PREVENTION AND TREATMENT OF VENOUS THROMBOSIS AND THROMBOEMBOLISM IN SURGICAL TREATMENT PELVIC NEOPLASMS
Summary. Venous thromboembolic complications — a collective concept that combines thrombosis of the saphenous and deep veins, as well as pulmonary thromboembolism. In the clinical practice of a doctor of any specialty, especially surgical, the possibility of timely diagnosis, treatment and preventive measures for deep vein thrombosis and pulmonary embolism are extremely important.
Purpose. To study the most informative measures for the prevention and treatment of venous thrombosis and thromboembolism in the surgical treatment of pelvic neoplasms.
Materials and methods. The analysis of the results of the examination and treatment of 112 patients observed for tumors of the pelvic organs and tumors of the retroperitoneal space is presented.
Results and discussion. When studying the initial state of the hemostasis system in 48 patients, a significant shortening of activated partial thromboplastin time (APTT), a 1.5-fold increase in the concentration of fibrinogen, which indicates activation of the procoagulant link, as well as an increase in platelet aggregation by 20.0 %, were established. Studies of the hemostatic system showed that surgical interventions and injuries contribute to increased hypercoagulation.
Conclusions. The most informative methods for determining thrombosis in the system of the inferior vena cava and the optimal examination algorithm are: ultrasonic dynamic angioscanning, determination of the amount of D-dimer, computer, magnetic resonance bolus venography and retrograde ileocavagography.
The use of unfractionated and low molecular weight heparins effectively prevents the development of thrombosis and thromboembolism before and after surgery and does not cause bleeding.
Nonspecific and specific prophylaxis of venous thrombosis and embolism allowed a 2.8-fold reduction in their number in patients of the main group.
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