EFFICIENCY OF PREOPERATIVE VENOUS THROMBOMOBOLISM PREVENTION IN ABDOMINAL SURGERY
About the author:
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The efficiency of venous thromboembolism prevention with different prophylactic schemes in preoperative period of abdominal surgery are presented in the article. 177 patients with preoperative prevention by unfractionated heparin, 136 patients with prophylaxis with low molecular heparin, 127 patients with preoperative cava-filters implantation, 119 patients with rivaroxaban prophylaxis were included in the research. The parameters were controled in the early postoperative period, before patients were discharge from the hospital and after 6 months-period. According to the results of the long-term retrospective analysis (2008-2017), the incidence of the lower extremities thrombosis for observation period significantly decreased – in 7,95% per year with the transition point for the period 2010-2011, after laparoscopic surgery – in 12,98% per annum with the transition point in 2013. It is proved that antithrombotic preoperative prophylaxis in abdominal surgery is effective and mandatory in patients with high risk of venous thromboembolism. The highest efficiency of preoperative prophylaxis is proved by using cava-filters (p=0,069). It was not shown the reliable differences between unfractionated and low molecular weight heparins in the incidence of venous thromboembolism (χ2=0,165; p1=0,685; p2=0,983) after usage of these schemes in preoperative period at surgical patients. It has been established that combined prevention schemes and usage of new oral anticoagulants (direct inhibitors of Xa factor) is more efficiency, than therapy with heparin for postoperative thrombosis prophylaxis (χ2=12,382; p1=0,002; p2=0,006). After long-term prospective observation it has been proven, that therapy with new oral anticoagulants (rivaroxaban) in postoperative period is necessary step for thromboembolism prevention, which contributes to the clott regression, such clinical as ultrasound.
venous thromboembolism, preoperative prophylaxis, abdominal surgery, heparin, enoxaparin, cavafilter, rivaroxaban
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 205-211 pages, index UDK 616.14-005.6/.7-089