Nenashko I. Risk factors of postoperative venous thrombosis - prevention, diagnosis and treatment

The dissertation given theoretical generalization and new decision of scientific target to reduce the incidence of postoperative thromboembolic complications in patients with planned surgical pathology. Inclusion of surgical stress factor scale Caprini J. et al. (2012) modifies system for determining the risk of postoperative venous thromboembolic complications, making it possible to select patients with high surgical stress, which stands at 24.59 %, with moderate – 18.84 %, the lowest – 13.21 %. Patients with non-specific connective tissue dysplasia characterized by high levels of endothelial dysfunction, increased activity of coagulation system, which significantly activated in terms of surgery. The final stage of the surgery accompanied by increased hypercoagulation and aggregation properties of blood on the background of the depressed state of the fibrinolytic system. Hypercoagulable for intraoperative phase is formed by the growth of the content of soluble fibrin monomer complexes, thrombin-fibrinous faction hemocoagulation cascade, which reveals the predominant impact of UFH. Thus, the modified scheme thromboprophylaxis for patients with planned surgical pathology involves intravenous administration of UFH immediately after surgery. UFH dosage determined by the level of surgical stress and on 3-5 days postoperative period medication is prescribed in the half of the initial dose three times a day. Specified conducted against the background of LMWH thromboprophylaxis (first injection at 6 or 12 hours at the end of the operation) according to industry standards. Taking into account risk factors for postoperative thromboembolism, has helped to reduce the incidence of postoperative thromboembolism with 19,17 % in patients with traditional thromboprophylaxis to 10.30 % in patients with modified scheme thromboprophylaxis.