Abstract
Objective. The study objective is to assess the efficacy of preventive care for thromboembolic complications after endoprosthetics of large joints depending on patients’ compliance.Methods: Prospective clinical examination of 686 patients aged 50–70 years, who underwent the endoprosthetics of knee and hip joints. Preventive care for thrombosis and embolism was performed according to three regimens: 1) monotherapy with parenteral low molecular weight heparins, 2) therapy with low molecular weight heparins converted to indirect anticoagulants, 3) administration of oral anticoagulants.Results: 376 patients (54.8%) fully complied with the medical recommendations. The rest 310 patients (45.2%), non-compliant patients, ignored medical prescriptions: refusal to take anticoagulants, spontaneous replacement of anticoagulants with antiplatelet agents, not taking medications as prescribed. Among compliant patients, deep vein thrombosis of lower extremities was registered in 9 cases (2.4%); among non-compliant patients, it was registered in 13 cases (4.2%).Conclusions: Deep vein thrombosis of lower extremities was registered significantly more often in non-compliant patients. To increase the efficacy of the prevention care for thromboembolic complications after endoprosthetics of large joints, more attention should be paid to explanatory work, explaining to patients the nature and negative consequences of compliance violations.
Highlights
The study objective is to assess the efficacy of preventive care for thromboembolic complications after endoprosthetics of large joints depending on patients’ compliance
Deep vein thrombosis of lower extremities was registered in 9 cases (2.4 %); among non-compliant patients, it was registered in 13 cases (4.2 %)
To increase the efficacy of the prevention care for thromboembolic complications after endoprosthetics of large joints, more attention should be paid to explanatory work, explaining to patients the nature and negative consequences of compliance violations
Summary
Цель: оценка эффективности профилактики тромбоэмболических осложнений при эндопротезировании крупных суставов в зависимости от комплаентности пациентов. Остальные 310 человек (45,2 %) – некомплаентные пациенты – игнорировали врачебные рекомендации: отказ от приема антикоагулянтов, произвольная замена антикоагулянтов на антиагреганты, прием лекарств в нерекомендованных дозах. Среди комплаентных пациентов тромбоз глубоких вен нижних конечностей зарегистрирован в 9 случаях (2,4 %), среди некомплаентных – в 13 случаях (4,2 %). Среди некомплаентных пациентов тромбозы глубоких вен нижних конечностей регистрировались достоверно чаще. Для повышения эффективности профилактики тромбоэмболических осложнений после протезирования крупных суставов следует больше внимания уделять разъяснительной работе, объясняя пациентам характер и негативные последствия нарушений комплаентности. Для цитирования: Пальшин Г.А., Павлов С.С., Марковчина М.Ю., Комиссаров А.Н., Марков П.В., Винокуров М.М., Костив Е.П., Устинова А.И., Пальшин В.Г. Частота тромбоэмболических осложнений в зависимости от комплаентности и вида профилактики при эндопротезировании крупных суставов.
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