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№4' 2018

SURGERY

International Medical Journal, Vol. 24., Iss. 4, 2018, P. 24−29.

FEATURES OF TREATMENT OF ACUTE THROMBOSIS OF DEEP VEINS OF THE LOWER EXTREMITIES

GU "Dnipro Medical Academy of Ministry of Health of Ukraine", Ukraine

Deep vein thrombosis is a complication that occurs in the postoperative period, during pregnancy and childbirth, trauma and many other diseases. The primary cause of thromboembolism in the pulmonary artery are acute thrombosis in the system of the lower vena cava, especially the deep veins of the lower extremities. Based on the comparative analysis, the advantages and disadvantages of conservative and surgical methods for the treatment of acute thrombosis of deep veins of the lower extremities in 120 patients were determined. The patients were divided into three groups: in Group 1 traditional conservative therapy was used; in Group 2 −− thrombectomy; in Group 3 −− systemic thrombolysis. The results were evaluated after the treatment according to the following criteria: blood coagulation system, inflammatory marker −− C−reactive protein, dynamics of regression of pain syndrome, dynamics of reduction of edema, ultrasound duplex scanning. Long−term results were studied by questioning patients using the CIVIQ questionnaire. Unsatisfactory results were associated with violations of patients' recommendations or anticoagulants inappropriate. The study showed the benefits of thrombectomy in comparison with the traditional ACT on the dynamics of clinical changes and hospital stay, but this method was accompanied by a large number of postoperative complications. The best treatment results were obtained with systemic thrombolysis, which was confirmed by the results of a study of the hemostasis system. However, its implementation may be limited in view of the presence of concomitant pathology and the risk of allergic reactions. In order to prevent hemorrhagic complications, systemic thrombolysis requires careful monitoring of the coagulogram.

Key words: deep vein thrombosis, anticoagulant therapy, thrombectomy, systemic thrombolysis.