Особенности ведения периоперационного периода у пациентов с хроническим гепатитом и циррозом печени при выполнении офтальмохирургических операций

Abstract

Purpose. Study of frequency and structure of hepatitis and cirrhosis among ophthalmic surgical patients. Material and methods. Among 1706 patients, 43 patients with chronic hepatitis and cirrhosis were selected. A clinical assessment of their etiology, severity, and possibility of performing ophthalmic surgery in these patients was carried out. Results. The average age of the selected 43 patients was 64.1 ± 9.7 years, in 72.1 % they conasist in elderly age group. 88.4 % had viral hepatitis (B, C, chronic HBV and HCV coinfection), 9.3 % had a toxic hepatitis, and one patient (2.3 %) had autoimmune hepatitis. Among hepatitis, HCV monoinfection prevailed (55.4 %). The vast majority (97.7 %) had minimal disease activity. Although violations of hemostasis system were detected in 9 patients, signs of significant hypocoagulability were observed in 3 people (6.9 %). After 3-days course of intramuscular injections of vitamin K 2–3 times a day, all 3 patients underwent successful ophthalmic surgery. 97.7 % of patients were admitted to surgery: 39 people. – in planned manner, 3 people – after medical preparation. In one patient with suspected acute viral hepatitis B, planned surgical treatment was postponed. Conclusion. In general structure of ophthalmic surgical patients, the proportion of patients with hepatitis and cirrhosis was 2.5 %. Viral hepatitis B and C prevailed (88.4 %), HCV monoinfection dominated (55.4 %). The vast majority of patients (97.7 %) had minimal hepatitis activity, 6.9 % had signs of significant hypocoagulability, which required their preoperative preparation. Keywords: hepatitis, cirrhosis, ophthalmic surgery