ULTRASONIC THROMBOELASTOGRAPHY IN THE SELECTION OF TREATMENT TACTICS WITH POST-OPERATIVE VENOUS THROMBOSIS

Abstract

The purpose of the study is to prevent the development of pulmonary embolism in patients with postoperative venous thrombosis of the lower vena cava system. The frequency of venous thromboembolic complications in patients with surgical diseases, which is 10-40 %, and high fatality determine the relevance of the suggested research. Materials and methods: the study of the condition of the venous system of the inferior vena cava (IVC) basin and the determination of the sonoelastographic properties of the venous thrombus was carried out by the ultrasonic system Siemens Acuson S2000 (Germany). In the course of the ultrasound investigation of the venous system of IVC, the localization, prevalence of thrombotic processes was established. At the end of the topical diagnosis of venous thrombus, the determination of soneleostographic properties of the thrombus was established by determining the propagation speed of the acoustic wave. Results: The study is based on the results of the examination and operative treatment of 729 patients, of which 205 (28.12 %) underwent surgery on the locomotor system, 378 (51.85 %) – on the abdominal organs, 146 (20.01 %) reconstructive operations on the aorta and trunk arteries of the lower extremities. Operative treatment was suggested to 316 (43.35 %) patients with the very high risk of developing thromboembolic complications, according to J. Caprini score and to 413 (56.65 %) patients with the high risk of developing thromboembolic complications. Thromboprophylaxis in surgery was used in accordance with the USSR provisions. In 118 (16.19 %) observations, the development of postoperative venous thrombosis has been established. Conclusions: embolonoblastic thrombi are considered venous thrombi of the basin of IVC, which on the ultrasonoelastographic examination of proximal segments of the venous thrombus are characterized by the rate of propagation of acoustic waves in the range of 2,5-2,8 m / s. Detection of embolic venous thrombosis is an indication for conducting surgical methods for the prevention of pulmonary embolism.