Передопераційний менеджмент пацієнток з артеріальною, легеневою гіпертензією в поєднанні з гінекологічними та хірургічними захворюваннями

Abstract

Purpose - tо determine the optimized system of preoperative preparation of patients with arterial (AH) and pulmonary hypertension (PH). Materials and methods. During the work, 35 patients were examined, 25 (71.4%) hypertensive patients were prepared for surgical treatment, 19 (54.3%) of them underwent planned operations, 6 (17.1%) underwent surgical urgent intervention. 10 (28.6%) patients with PH were examined and prepared for surgery, in which surgical intervention was performed as planned. The patients who underwent planned operations were examined according to the standards of the medical institution, taking into account protocols of the European Association of Cardiologists (ESC) from 2022. Results. Stage I AH was diagnosed in 15 (42.9%) patients, and stage II - in 10 (28.6%) women. Stage I PH was detected in 7 (20%) patients, and stage II - in 3 (8.6%) women. When preparing patients for surgery, drug therapy of AH was carefully selected, which affected different links of the pathogenesis of the disease. In patients with PH, who are scheduled for surgical treatment, drug therapy in many cases is clearly regulated and prescribed in accordance with the clinical manifestations of the disease and the course of the perioperative period. No cardiovascular complications were detected in patients who were operated on as planned in compliance with the developed scheme of preoperative preparation. Blood pressure in most cases was within the age norm, there were no cases of venous thromboembolism, the severity of heart failure did not increase. Conclusions. It is recommended to strictly follow the scheme of preoperative preparation, starting from the prehospital stage of examination and treatment of patients with AH and PH. Determination and adherence to the optimized scheme of preoperative preparation proved to be effective, contributed to the absence of complications from the cardiovascular system, stabilization of blood pressure in the perioperative period, was characterized by the absence of cases of venous thromboembolism, and the severity of heart failure did not increase. The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution. Informed consent of patients was obtained for the study. No conflict of interests was declared by the authors.