ULTRASOUND DIAGNOSIS OF VENOUSTHROMBOSIS IN THE COURSE OF PROPHYLACTIC DRUG THERAPY IN THE ACUTE PHASE OF TRAUMA
Abstract
INTRODUCTION. High risk of venous thrombosis in patients with multisystem trauma is associated with a number of precipitating factors, such as direct damage to vessels, prolonged immobilization, major changes in the hemostatic system, as well as possible surgical intervention.
THE PURPOSE OF THE STUDY. Analysis of the incidence, echosemiotics, and evolutionof venous thrombosis in the course of various prophylactic drug therapies in patients with polytrauma.
METHODS. The results of leg veins ultrasonography in 610 patients with various prophylactic drugtherapies have been analyzed over time. Antiplatelet agentswere received by 314 patients of the first group, low molecular weight heparins — 186 patients of the second group, oral anticoagulants — 110 patients of the third group. THE RESulTS Evolved thromboses varied in frequency (52.5% in the first group, 15.6% in the 2nd group and 10% in the 3rd group), prevalence, nature of the proximal border, with an increase in the proportion of nonocclusive lesions in the 2nd and 3rd groups, as well as in start time and degree of recanalization.
CONCLUSION. Low molecular weight heparins and oral anticoagulants reduce the risk of venous thrombosis by 3.3 and 5 times respectively, compared to the group of patients who did not receive anticoagulants in the early posttraumatic period; recanalization begins 1−2 weeks earlier with more effective restoration of the lumen. As the number of thromboses in the course of modern anticoagulants decreases, the proportion of non-occlusive thromboses including the floating onesgrows, requiring ultrasoundobservation.
About the Authors
L. O. Mezhebitskaya
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow
Russian Federation
Russian Federation
E. Y. Trofimova
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow
Russian Federation
Russian Federation
P. A. Ivanov
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow
Russian Federation
Russian Federation
E. V. Kungurtsev
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow
Russian Federation
Russian Federation
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For citations:
Mezhebitskaya L.O., Trofimova E.Y., Ivanov P.A., Kungurtsev E.V. ULTRASOUND DIAGNOSIS OF VENOUSTHROMBOSIS IN THE COURSE OF PROPHYLACTIC DRUG THERAPY IN THE ACUTE PHASE OF TRAUMA. Russian Sklifosovsky Journal "Emergency Medical Care". 2015;(1):38-43.
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