Khvalyboha D. Thrombosis of the inferior vena cava system in planned and emergency surgery – prevention of pulmonary embolism

The dissertation is devoted to prevention of pulmonary embolism development and increase of efficiency of treatment of inferior vena cava thrombosis in planned and emergency surgery. Depending on the level of perioperative surgical stress response in patients with planned surgical pathology of the abdominal cavity, orthopedic pathology, occlusive-stenotic diseases of the aorta and main arteries of the lower extremities, determined by the concentration of glucose and cortisol in the blood, the levels of risk of thromboembolic complications in surgical patients were established: high, moderate, low and excessively high risk of postoperative venous thrombosis. Thus, in patients with a high risk of thromboembolic complications their frequency was 25.93 %, with a moderate level – 22.22 %, with a low level – 18.52 % and in patients with an excessively high risk – 33.33 %. A directly proportional dependence of the development of venous thromboembolic complications on the level of surgical stress response was established. It was established that patients with clinical and laboratory signs of nonspecific connective tissue dysplasia have an increased risk of developing venous thromboembolic complications in the perioperative period. It was found out that the combination of clinical and laboratory signs of nonspecific connective tissue dysplasia and medium and high levels of surgical stress response in surgical patients potentiates the risk of perioperative venous thromboembolic complications, which requires correction of thromboprophylaxis. It was proposed to establish the embolism risk of venous thrombosis by determining the speed of shear wave propagation in thrombotic masses by ultrasound thromboelastography.