RESUMEN
The risk factors of venous thromboembolism (VTE) in 1146 patients who were underwent operated for the diseases of digestive organs, for obliterating atherosclerosis of abdominal aorta and peripheral arteries, diseases of bones and joints were studied. The methods of VTE prevention in these patients were studied. To evaluate the risk of VTE we designed the special chart. Three levels of risk of VTE: low, moderate and high were distinguished. The specific prophylaxis of the VTE using low molecular weight heparin fraxiparine was given to the patients moderate (90.7%) and high (93.3%) risk degree.
Asunto(s)
Complicaciones Intraoperatorias , Tromboembolia/diagnóstico , Tromboembolia/prevención & control , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Factores de RiesgoRESUMEN
In the article are presented the results of study and treatment of 804 patients with polytrauma. In part of the patients in early period of the traumatic disease have been studied in complex the states of hemodynamics (circulating blood volume, specific peripheral resistance, cardiac index, central venous pressure, arterial pressure, heart rate) and metabolism (total protein, basal metabolism, the level of endogenous nitrogen in urine). On the basis of the obtained data there is proposed the evaluation of the hemodynamics changes, energetic and plastic losses at polytrauma that formed the basis of the pathogenetic therapy ensuring simultaneous correction of the detected disturbances. It allowed the author to reduce the number of unfavourable outcomes (anatomical by 20.9% (p less than 0.05), functional by 20.7% (p less than 0.05), labour by 19.5% (p less than 0.05) and lethality (at the multiple damages by 2.0% (p less than 0.05), at associated craniocerebral injury by 3.0%, at associated trauma of internal organs and locomotor system by 6.0% (p less than 0.05).
Asunto(s)
Gasto Cardíaco Bajo/etiología , Hemodinámica/fisiología , Homeostasis/fisiología , Traumatismo Múltiple/fisiopatología , Choque Traumático/fisiopatología , Gasto Cardíaco Bajo/terapia , Terapia Combinada , Humanos , Traumatismo Múltiple/complicaciones , Choque Traumático/complicaciones , Factores de Tiempo , Desequilibrio Hidroelectrolítico/etiología , Desequilibrio Hidroelectrolítico/terapiaRESUMEN
Hemodynamic disorders were studied in 60 patients with isolated craniocerebral injury and in 145 patients with craniocerebral injury and injury to the locomotor apparatus. The authors studied the changes in the mean dynamic arterial pressure, the cardiac contraction rate, the cardiac output, the general peripheral vascular resistance to blood flow, and the circulation volume. It was found that in isolated craniocerebral injury the circulation volume deficiency does not exceed 13%, the mean dynamic arterial pressure and the cardiac output increase. In cases of craniocerebral injury combined with injury to the locomotor apparatus the required level of the mean dynamic arterial pressure is maintained by a higher cardiac output and an increase in the general peripheral vascular resistance to the blood flow. The changes in hemodynamic indices including the circulating volume deficiency depend on the degree of injury to the locomotor apparatus and of craniocerebral injury.