Klinichna khirurhiia · 2014
[Algorithm of treatment postthrombotic disease of the lower extremities].
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Buzmakov D L
Аннотация
The results of application of pathogenetically substantiated diagnostic algorithm for determination of the treatment method in patients, suffering postthrombotic disease of the lower extremities, are adduced. Using algorithm proposed a clinical state was estimated, subfascial pressure on the shin was determined, ultrasound duplex scanning (USDS) of venous system was conducted, the stimulation electroneuromyography of the shins done, and a level of D-dimer (DD) with activity of antithrombin-III (AT--III) in general and regional blood flow with calculation of its ratio were established. In 33 (31.1%) patients a conservative therapy was conducted, in 34 (32.1%)--a postponed surgical intervention, in 39 (36.8%)--surgical correction of the venous blood flow, in 22 (20.8%)--preparation and closure of trophic ulcers in accordance to the clinic method. Determination of the DD level and the AT-III activity together with data of USDS have permitted to establish differentially the indications for performance of a vein-correcting operative interventions.