Abstract
Disturbances in the system of hemostasis and vascular complications is the topical clinical problem, requiring profound study with the development of treatment and prophylaxis algorithm. Thrombus-hemorrhagic complications in patients with chronic myeloproliferative (CMPN) neoplasias are caused by the presence of plethoric and myeloproliferative syndromes, findings of hemogram (level of erythrocytes, thrombocytes, leukocytes, hematocrit index) and hemostasiogram testify to this. A case of thrombus-hemorrhagic complication in a female patient with chronic myeloproliferative neoplasia was considered. Carrying out differential diagnostics requires performing additional investigations: USI, CT with defining of hemostasiogram, hemogram findings, their thorough monitoring when surgical intervention is needed. This diagnosis for the first time was made in conditions of surgical in – patient unit. In pre- and postoperative periods as well as for prevention of vascular complicatients in the patient with CMPN it is necessary to mandarory administer agents which correct hematologic status and rheologic indices. This clinical case was analyzed with the aim to draw doctors’ aftention to complexities in diagnostics and defining treatment tactics for patients with thrombus-hemorrhagic complications: necessity to establish all possible risk factors of vascular events development and to carry out constant hemostasiologic menitoring for preventing lethal outcomes.
Highlights
Aftention to complexities in diagnostics and defining treatment tactics for patients with thrombus-hemorrhagic complications: necessity to establish all possible risk factors of vascular events development and to carry out constant hemostasiologic menitoring for preventing lethal outcomes
neoplasias are caused by the presence
hemostasiogram testify to this. A case of thrombus-hemorrhagic complication
Summary
Aftention to complexities in diagnostics and defining treatment tactics for patients with thrombus-hemorrhagic complications: necessity to establish all possible risk factors of vascular events development and to carry out constant hemostasiologic menitoring for preventing lethal outcomes. Ɍ ɷɬɨɣ ɤɚɬɟɝɨɪɢɢ ɛɨɥɶɧɵɯ ɭɝɪɨɡɚ ɪɚɡɜɢɬɢɹ ɬɪɨɦɛɨ-ɝɟɦɨɪɪɚɝɢɱɟɫɤɢɯ ɨɫɥɨɠɧɟɧɢɣ (ɌȽɈ) ɧɚɪɚɫɬɚɟɬ ɩɨ ɦɟɪɟ ɩɪɨɝɪɟɫɫɢɢ ɩɥɟɬɨɪɢɱɟɫɤɨɝɨ ɢ ɦɢɟɥɨɩɪɨɥɢɮɟɪɚɬɢɜɧɨɝɨ ɫɢɧɞɪɨɦɨɜ, [3, 8]- ɬɪɨɦɛɨɡɵ ɩɪɟɨɛɥɚɞɚɸɬ ɧɚɞ ɤɪɨɜɨɬɟɱɟɧɢɹɦɢ, ɚɪɬɟɪɢɚɥɶɧɵɟ ɬɪɨɦɛɨɡɵ - ɧɚɞ ɜɟɧɨɡɧɵɦɢ [8]. Ɉɨɤɚɡɚɬɟɥɢ ɫɩɨɧɬɚɧɧɨɣ (ɧɟɨɛɪɚɬɢɦɨɣ) ɚɝɪɟɝɚɰɢɢ ɬɪɨɦɛɨɰɢɬɨɜ ɢ ɮɭɧɤɰɢɨɧɚɥɶɧɨɣ ɚɤɬɢɜɧɨɫɬɢ ɧɟɣɬɪɨɮɢɥɨɜ ɭ ɛɨɥɶɧɵɯ ɏɆɉɇ ɩɪɟɜɵɲɚɸɬ ɧɨɪɦɚɬɢɜɧɵɟ ɜɟɥɢɱɢɧɵ [4]. Ʌɟɱɟɧɢɟ ɢ ɩɪɨɮɢɥɚɤɬɢɤɚ ɫɨɫɭɞɢɫɬɵɯ ɫɨɛɵɬɢɣ ɩɪɢ ɏɆɉɇ ɬɪɟɛɭɸɬ ɧɚɡɧɚɱɟɧɢɹ ɚɞɟɤɜɚɬɧɨɣ ɷɬɢɨɩɚɬɨɝɟɧɟɬɢɱɟɫɤɨɣ ɬɟɪɚɩɢɢ, ɫɬɚɛɢɥɢɡɚɰɢɢ ɮɭɧɤɰɢɨɧɚɥɶɧɨɣ ɚɤɬɢɜɧɨɫɬɢ ɮɨɪɦɟɧɧɵɯ ɷɥɟɦɟɧɬɨɜ ɤɪɨɜɢ ɢ ɭɥɭɱɲɟɧɢɹ ɪɟɨɥɨɝɢɱɟɫɤɢɯ ɩɨɤɚɡɚɬɟɥɟɣ [5, 8, 9].
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