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Khirurgii

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Year 2015 Vol. 23 No 1

GENERAL AND SPECIAL SURGERY

Y.T. TSUKANOV, A.I. NIKOLAYCHUK

EVALUATION OF FACTORS AFFECTING THROMBUS REGRESSION OF SUBCUTANEOUS VEINS OF THE LOWER LIMBS IN ANTICOAGULATION THERAPY

SEE HPE "Omsk State Medical Academy",
The Russian Federation

Objectives. To assess the factors affecting the thrombus regression using anticoagulants in patients with subcutaneous venous thrombosis.
Methods. 65 patients receiving anticoagulants in the adjuvant therapy within 1-14 days, (on the average 5,05 days) after thrombosis development have been examined. An evaluation of thrombus changes, venous wall and paravasal cellulose was perfomed by duplex ultrasonography.
Results. Mass and density of thrombus, distal displacement of its borders, reduction of inflamed venous wall and paravasal cellular tissue have been reduced in all patients. Regression began in 1-10 days (on the average 5,37 day). Depending on the rate of regression, the observations are divided into two subgroups: 1) relatively quick - within a week (16), and 2) relatively slow – within a month (49 people). It has been found out that treatment with anticoagulants started up to 3 days, low echodensity of the proximal part of thrombus, cellular character, unexpression of paravasal inflammation throughout the thrombus and its proximal part make the significant probability of rapid thrombus regression (p=0,000001).
Conclusion. Thrombosis regression of the subcutaneous veins in the treatment process, including anticoagulants, in the nearest terms passes the way of thrombolysis with a minimal damage of the venous wall by reducing its mass and density, increasing its cellular structure. Rapid regression of the proximal part of the subcutaneous vein thrombus occurs in treatment beginning up to 3 days from the moment of a blood clot formation, its low echodensity, thickness of the inflamed paravasal tissue in the proximal part of the blood clot not more than 5 mm and for thrombus not more than 7 mm. In case of ligation of large subcutaneous veins to prevent the pulmonary embolism a clot lysis slows down.

Keywords: subcutaneous vein thrombosis, anticoagulants, regression of thrombosis, thrombolysis
p. 57-62 of the original issue
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Address for correspondence:
644043, Rossiyskaya Federatsiya,
g. Omsk, ul. Lenina, d. 12,
GOU VPO "Omskaya gosudarstvennaya
meditsinskaya akademiya",
kafedra khirurgicheskih bolezney i urologii PDO,
tel. office 7 3812 36-07-62,
e-mail: alex79nik@mail.ru,
Nikolaychuk Aleksandr Ivanovich
Information about the authors:
Tsukanov Y.T. MD, professor, a head of the surgical diseases and urology chair of SBEE HPE "Omsk State Medical Academy".
Nikolaychuk A.I. An assistant of the surgical diseases and urology chair of SBEE HPE "Omsk State Medical Academy".
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