Comparative evaluation of preventive anticoagulant therapy regimens in the wounded

Abstract

Introduction. Currently, the issues of prescribing anticoagulant therapy to the wounded are poorly studied, the doses of drugs and the timing of its implementation have not been determined.Aim. To study various modes of anticoagulant therapy for the prevention of venous thrombosis of the lower extremities in the wounded after surgery using the parameters of the plasma hemostasis system and the Thrombodynamics test.Materials and methods. A prospective study was conducted, which included 90 wounded with mine-explosive/gunshot injury receiving anticoagulant therapy in preventive doses. The studies were carried out on the equipment of the Thrombodynamics recorder (HemaCor, Moscow). The patients were divided into 3 groups: 1 group, which included 30 patients taking rivaroxaban at a dose of 10 mg/day, 2 group of 30 patients receiving enoxaparin sodium at a dose of 40 mg once a day, 3 group consisting of 30 patients receiving enoxaparin sodium 40 mg 2 times a day. In the dynamics of treatment, the parameters of the plasma hemostasis system and the parameters of the Thrombodynamics test were evaluated.Results. It was revealed that during preventive anticoagulant therapy, there were no significant differences in the standard parameters of the coagulogram, when studying the parameters of the Thrombodynamics test, significant differences wereobserved between groups 1 and 3 in values (V/VSt, Vi, Tlag, СS), between group 2 and 3 in parameter (V/VSt, Vi, Tlag, СS), between group 1 and group 2 in the value of D. A statistically significant relationship was found between the Thrombodynamics parameter D and the indicators of TV, prothrombin by Quick, and fibrinogen content.Conclusion. The Thrombodynamics test can be used as a potential tool for a personalized approach to monitoring the hemostasis system in the wounded.