Zusammenfassung

Aim: To study an influence of the different variants of thromboprophylaxis on activation of blood coagulation test on the background of surgical aggression. D-dimer concentration in serum is in direct proportion to fibrinolysis activity and to an amount of lysed fibrin. At the same time fibrinolysis activation is followed with an increase of formation of products of fibrin degradation (PFD) that interact with fibrin-monomers and increase the number of SFMC. Materials and methods : After informed consent 200 patients were prospectively divided into groups depending on preparation and regimen of thromboprophylaxis. 1 group (n=30) – ungraded heparin (UGH) (5000 ОD) for 2 hours before surgery 2 times during 7 days after it. 2 group(n=30) nadraparin calcium 9500 anti-Ха МO (0,3 ml) for 2 hours before surgery 2500 МО 1 time for a day 7 days after surgery; 3 group(n=48) – endoxaparin sodium(0,2 ml) for 2 hours before surgery 1 time a day 7 days; 4 group(n=29) endoxaparin sodium(0,2ml) for 8 hours before surgery, 0,2 ml 1 time a day 7 days; 5 group(n=34) – bemiparin sodium(0,2 ml) for 2 hours before surgery 0,2 ml 1 time a day 7 days; 6 group(n=29) bemiparin sodium(0,2ml) in 6 hours after surgery 1 time a day 7 days. Patients were comparable on sex, concomitant pathology, class АSA (1-2) and type of surgical intervention. There were studied the number of thrombocytes, prothrombin time (PT), INR AFTT, fibrinogen, Х-а factor activity, antithrombin, 111 (AT111), protein C, SFMC, d-dimer before surgery, on 1,5 and 7 day after it. Results and discussions : On the 1 day of postsurgical period the most influence on D-dimer level had presurgical thromboprophylaxis (TPP) with UGH and nadroparin calcium. So the D-dimer level exceeded norm respectively by 67 % (р=0,017) and 65,9 % (р<0,05). In patients of 3 and 4 groups D-dimer level was the lowest that formed deficiency by 56 % (р<0,05) and 52,7 % (р<0,05) from the norm respectively. At the same time an analysis of patients with pre- and postsurgical start of TPP with ...