Complex treatment of purulonecrotic process of diabetic foot syndrome (wagner, stage 3-4), taking into account hemostasis index
DOI:
https://doi.org/10.11603/2414-4533.2020.1.10746Keywords:
diabetic foot syndrome, fibrinogen, X factor, RivaroxobanAbstract
The aim of the work: to study some hemostasis aspects in patients with diabetic foot syndrome (DFS).
Materials and Methods. We examined and observed 63 patients with DFS (Wagner, st. 3-4). Patients were separated into two groups, that were similar by gender, (59.4±8.3) year old. Diabetes mellitus was diagnosed 5–15 years ago, 74 % of popularity HbA1c blood level was (7.9±1.39) %.
All patients got common therapy, small amputation, catheterization of a. epigastrica inferior. Starting from second postoperative day, rivaroxoban 15 mg twice daily, up to 10 days, followed by switching to 10 mg once daily for 6 months, diosmin 450 mg, hesperidin 50 mg for 1 month. Group I (39 patients) got prescribed therapy. In group II (24 patients), osteoperforation of tibia of injured leg was performed.
Results and Discussion. Both groups, at the moment of hospitalization, TcpO2 was (21.3±5.4) mmHg. In 64.3 % of patients we found increasing of fibrinogen level up to two times. On tenth postoperative day, fibrinogen level decreased up to normal ranges. Х-factor range, at hospitalization, was (0.04±0.004) g/l, (p <0,01). On a third day, in group I, on a background of increasing of TcpO2 on 8.8 % and pronounced inflammatory changes of tissues, was (0.04±0.01) g/l. On a tenth day, at presence of secondary healing of wound (0.02±0.01) g/l, (p <0.1). In group ІІ patients, on a third day TcpO2 increased on 27 %, Х-factor range was (0.04±0.01) g/l. On a tenth day, at presence of primary healing of wound (0.02±0.01) g/l, (p <0.1), on a thirtieth day (0.01±0.01) g/l.
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