СПОСОБ ОПРЕДЕЛЕНИЯ РИСКА РАЗВИТИЯ ГИПЕРКОАГУЛЯЦИИ У БОЛЬНЫХ С ПОРТАЛЬНОЙ ГИПЕРТЕНЗИЕЙ ЦИРРОТИЧЕСКОГО ГЕНЕЗА ПОСЛЕ ПРОВЕДЕНИЯ ПОРТОСИСТЕМНОГО ШУНТИРОВАНИЯ
FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to surgery, and can be used to determine the risk of hypercoagulation in patients with hepatic cirrhosis complicated by portal hypertension after portosystemic shunt placement. Find out from the patient the time that has passed since the ascertainment of esophageal-gastric bleeding. Evaluate the severity class of hepatic cirrhosis by Child-Pugh. Determine the parameters by the method of thrombodynamics: the rate of formation of the blood clot, the growth inhibition of the blood clot, the initial growth rate of the blood clot, the steady growth rate of the blood clot, the size of the clot after 30 min, the density of the clot, the time of appearance of spontaneous clots. Following values are determined: the level of D-dimer, the level of SFMCs (soluble fibrin monomer complexes). Triplex scan of the vessels of the portal zone is performed and the following parameters are determined: the linear velocity of blood flow in the portal vein, hepatopetal or hepatofugal character of the blood flow in the portal vein, the diameter of the portal vein, and the rate of blood flow in the shunt after TIPS procedure (transjugular intrahepatic portosystemic shunting). Estimate the received indicators in points. Sum all the points. At the sum of scores is less than or equal to 5, the patient is referred to the risk group A – there is no risk of hypercoagulability. At a total of 6–10 points, the patient is referred to the risk group B – the risk of hypercoagulability is moderate. At the sum of 11–15 points, the patient is referred to the risk group C – the risk of hypercoagulability is high.EFFECT: method allows to identify the risk of hypercoagulability, to improve the results of surgical treatment of patients with hepatic cirrhosis complicated by portal hypertension after portosystemic shunt placement by evaluating the complex of the most significant indicators.1 cl, 11 tbl, 3 exИзобретение относится к медицине, а именн
