USING THE THROMBODYNAMICS TEST IN THE INTEGRATED PERIOPERATIVE MONITORING OF THE BLOOD COAGULATION SYSTEM IN SURGICAL PATIENTS

Aim.The research was conducted to evaluate the possibilities of the "Thrombodynamics" test in the integrated monitoring of the blood coagulation system and the choice of the method of prophylaxis of thromboembolic complications in the postoperative period in surgical patients.Materials and methods. 123 patients were operated for acute surgical pathology of abdominal organs. The "Thrombodynamics" test was used in a complex assessment of the state of the blood coagulation system. After the statistical processing by the methods of variation statistics, the results were used to predict the risk of the occurrence and changes in the volume of therapy for thromboembolic complications, taking into account the current understanding of the thrombodynamic properties of the fibrinous clot. Correction of the hemostasis system was based on "Russian Clinical Recommendations for the Diagnosis, Treatment and Prevention of Venous Thromboembolic Complications" approved by the Expert Meeting on May 20, 2015.Results.It was found that 101 (82.1%) patients had abnormalities in the blood coagulation system after the surgery for acute abdominal cavity diseases complicated by peritonitis. We established the direct dependence of the predicted risk of thromboembolic complications on the degree of severity of secondary peritonitis. 52 (42.3%) patients needed a correction of thromboprophylactic therapy, which made it possible to exclude the occurrence of venous thromboembolic complications.Conclusion. The use of the "Thrombodynamics" test in the complex evaluation of the qualitative characteristics of the blood coagulation system in surgical patients with a complicated course of the disease in the perioperative period makes it possible to objectively assess the risks of the thromboembolic complications and to correct a thromboprophylactic therapy to exclude the thromboembolic complications.

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Laparoscopic appendectomy during pregnancy: hemostasiological aspects

Kazan medical journal ◽

10.17750/kmj2016-823 ◽

2016 ◽

Vol 97 (6) ◽

pp. 823-827

Author(s):

I I Petrashenko

Keyword(s):

Acute Appendicitis ◽

Pregnant Women ◽

Blood Coagulation ◽

Laparoscopic Appendectomy ◽

Abdominal Cavity ◽

Coagulation System ◽

Laparoscopic Treatment ◽

Clotting System ◽

Blood Coagulation System ◽

D Dimer

Aim. To study and evaluate changes in blood coagulation system in laparoscopic treatment of acute appendicitis in different pregnancy terms.Methods. In a conducted study сhanges in blood coagulation system were evaluated in 75 pregnant women in different gestation periods who underwent laparoscopic appendectomy. Gestational age was from 4-5 to 35-36 weeks. Interventions were performed with the use of endovideosurgical complex «Olympus» OTV-SC. The pressure of carbon dioxide in the abdominal cavity was within 10-12 mm Hg. The indicators of blood coagulation system were evaluated with the use of automatic coagulometer «Amelung Coagulometr KC 4A» (Trinity Biotech, Ireland). For the diagnosis of intravascular coagulation D-dimer level in blood plasma was evaluated with immunoturbodimetric assay with latex-test «Tina-quant а D-Dimer» («Roche Diagnostics», USA) in the system «Roche/Hitachi Сobas c 6000». Fibrinolytic activity was evaluated with the use of M.A. Kotovschikova and B.I. Kuznik’s method.Results. It was found that changes in hemostasis system during laparoscopic treatment of acute appendicitis in pregnant women indicate significant increase of blood coagulation potential, both before and after laparoscopic appendectomy. This state of blood clotting system can be regarded as adequate adaptive response to aggression, designed to reduce probable or actual bleeding.Conclusion. Hemostasiologic indices during laparoscopic treatment of acute appendicitis in pregnancy are characterized by a significant intensification of the blood coagulation potential, however activation of the regulatory mechanisms of blood coagulation during endovideosurgical intervention is within the physiological norms; these changes are minimal, and laparoscopic appendectomy is the method of choice for pregnant women in different periods of gestation.

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Thrombotic complications and changes in the hemocoagulation system in acute myocardial infarction

Kazan medical journal ◽

10.17816/kazmj64469 ◽

1982 ◽

Vol 63 (5) ◽

pp. 7-9

Author(s):

L. A. Shcherbatenko ◽

S. Z. Gabitov ◽

I. E. Voronina ◽

R. I. Litvinov

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Blood Coagulation ◽

Disseminated Intravascular Coagulation ◽

Coagulation System ◽

Blood Coagulation System ◽

Maximum Activation ◽

Great Vessels ◽

Anticoagulant System ◽

Thrombotic Complications

A natural relationship was revealed between the incidence of thrombotic complications and changes in the indicators of the blood coagulation system in patients with acute myocardial infarction. The totality of tests revealed two periods of maximum activation of the blood coagulation system, combined with inhibition of the anticoagulant system, on the 3-5th and 9-17th days of illness. These periods coincide with the time of the maximum incidence of thrombosis of the great vessels, disseminated intravascular coagulation and recurrence of myocardial infarction.

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