Ways Of Prevention Of Thromboembolic Complications In Trauma Patients
DOI:
https://doi.org/10.11603/2414-4533.2017.1.7507Keywords:
thromboembolism, injuries, prevention.Abstract
The aim of the work: to analyze the prevention of thromboembolic complications in trauma patients who underwent surgery.
Materials and Methods. Patients were examined in the Traumatology Department of Ternopil City Municipal Emergency Hospital. In 2016 1410 patients of different ages, who were divided into 3 groups had been hospitalized. The first group – 263 men (18.6 %) consisted of patients with polytrauma and unsatisfactory outlook to life and disease severity. The second group included patients with combined trauma – 462 people. (32.8 %) – with a doubtful prognosis for life. The third group – 685 people (48.6 %) – patients with isolated trauma and pleasant good-effects of treatment. All patients, besides addition to general clinical examination, determine the number of platelets, clotting time, duration of bleeding and studied coagulation (prothrombin index, prothrombin activity trombotest, total fibrinogen, fibrinogen, fibrinogen A, activated recalcification time). State of the venous system of the lower limbs studied using distal ascending phlebography, color Doppler and duplex ultrasonography using SIMENS ACUSSON X 300.
Results and Discussion. All patients in full volume underwent prevention of thromboembolic complications through the use of anticoagulants low-molecular weight and required necessary complex kinetic treatment. Cybor in medical dose was administered from the first day of patient’s stay in the hospital for 10–14 days postoperative once a day subcutaneously in the abdominal area. For patients with moderate risk and high operational risk (major surgery, age over 40, obesity, serious comorbidities), cybor was administered 5000–7500 IU per day during the patient's stay in the hospital. If you suspect or changes in the availability of venous leg, in patients with a history burdened, conducted dressing elastic stockings and elastic bandaging. Movements during surgery in ankle joints, early activation of patients after surgery, physiotherapy were carried out in all patients. Medicines, that increase venous tone used in the treatment of patients with chronic venous insufficiency. In individuals with subacute and chronic thrombophlebitis of subcutaneous veins performed surgical prophylaxis of thromboembolic complications. Сrossectomy performed in 9 (1.9 %) patients, as a first step before surgery.
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