Kirpichnikova K. Diagnosis, prophylaxis and correction of thrombophilia in patients undergoing hip replacement

The manuscript colligates the results of complex blood coagulation studies in vitro and effects of the prophylaxis of perioperative deep vein thrombosis complications in 100 patients undergoing hip replacement. The status of blood coagulation was analyzed by using new lowfrequency haemoviscoelastography technic accompanied by standard laboratory tests screening. Signs of thrombophilia have been detected before surgery. The influence of different anesthetic technics, i.e. prolonged epidural anesthesia, general total intravenous anesthesia with ALV and combination of both of them, were investigated in regard of surgery associated coagulopathy. The advantages of combination method of anesthesia were proved using it as a part of complex strategy of coagulation disorders correction. The effects of vary methods of anticoagulant prophylactic therapy were investigated. The benefits of LMWH Clexane (Enoxaparine) were established based on its selective influence on haemostasis factors. The combination of epidural plus general total intravenous anesthesia in complex with Clexane therapy for hip replacement surgery affected coagulation on all stages of clot formation with maximum anticoagulant effect and in this regard reduces perioperative deep vein thrombosis and embolic complications significantly.