Year 2017 Vol. 25 No 3




SHEE "I.Y. Horbachevsky Ternopil State Medical University"
the Ministry of Health of Ukraine1,Ternopil,
Uzhhorod National University2, Uzhhorod,

Objectives. To study the changes in the hemostatic system during surgery and in the early incisional period in patients with the planned surgical pathology.
Methods. The study included patients (n=183) who underwent arthroplasty of the hip joint, osteosynthesis of the femur, operations on the digestive tract, hepatopancreatoduodenal region, urinary system, revascularization surgeries on aorta and main arteries. The levels of indicators of coagulative, fibrinolytic and antiplatelet blood systems were being determined at all stages of surgery.
Results. The development of hypercoagulation syndrome, with a maximum of its development by 3 hours after the operation was occurred in the intraoperative stage of the surgery and within the early incisional period. The basis of the later is the increased content of thrombin-fibrin fraction. Development of the hypercoagulation syndrome occurs in case of activation of the aggregate system against the depressed fibrinolytic link of the coagulation system.
Postoperative venous thrombosis was diagnosed in 45 (24,59%) patients: the deep vein system 37 (82,22%) patients, and superficial vein system 8 (17,78%) patients. In the first 72 hours postoperative venous thrombosis was diagnosed in 15 (33,33%) patients.
Conclusion. The development of the hypercoagulation syndrome immediately within the surgery and in the early incisional period has been established. The process generally develops due to the accumulation of fibrinogen and thrombin fractions on the background of low activity of the fibrinolytic system with enhanced platelet aggregation ability. Hypercoagulation syndrome leads to thrombotic events. One of the main constituent components of the hypercoagulation syndrome is considered to be fibrinogen and thrombin factor, the predominant influence on it is provided by unfractionated heparin (UFH). Thromboprophylaxis should be started at the end of surgery with UFH and be continued within the first 72 hours of the postoperative period, against the administration of low molecular heparin according to the industry specific standards showing the dominant influence on factor.

Keywords: hypercoagulation, deep vein thrombosis, venous thromboembolism, thromboprophylaxis, anticoagulation, low molecular heparin, incisional period
p. 267-272 of the original issue
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Address for correspondence:
47001, Ukraine, Ternopil,
Maydan Voli, 1, HSE "Ternopil
State Medical
University named by I. Gorbachevsky
Ministry of Health of Ukraine",
department of surgery 2
Svyatoslav Y. Kostiv
Information about the authors:
Wenger IK MD, professor, head of Surgery Department N2, State Medical Institution "Ternopil State Medical University named after I.Y. Gorbachevsky Ministry of Health of Ukraine".
Rusin V.I. MD, Professor, professor of Department of Surgical Diseases, Uzhgorod National University.
Kostiv S.Y. MD, Ass. Professor of Surgery Department N2, State Medical Academy of Ternopol "Ternopil State Medical University named after I.Y Gorbachevsky Ministry of Health of Ukraine".
Zarudna O.I. PhD, Ass. Professor of Department of clinical immunology, allergology and general care, STI "Ternopil State Medical University named after I.Y Gorbachevsky Ministry of Health of Ukraine";
Kostiv O.I. PhD, Ass. Professor of Department of anesthesiology and reanimatology "Ternopil State Medical University named after I.Y Gorbachevsky Ministry of Health of Ukraine".
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