Целью исследования было снижение периоперационной кровопотери у
больных с гигантской миомой матки. В результате исследования были получены данные о том, что использование антифибринолитической терапии в виде
назначения транексамовой кислоты за 30 мин до оперативного вмешательства в дозе 20 мг/кг с последующей инфузией 5 мг/(кг·ч) в течение первых послеоперационных суток позволяет снизить периоперационную кровопотерю на
29 %. У больных второй группы уровень гемоглобина на вторые послеоперационные сутки был выше на 10 % (р<0,05), кровопотеря была ниже на 29 %
(р<0,05), сроки пребывания в стационаре были меньше на 24 % (р<0,05).
Intraoperative blood loss, can act as an aggravating factor during the
perioperative period. Reduced blood loss is an urgent problem in patients with uterine
cancer, which is planned surgery.
The aim of the study was to reduce perioperative blood loss in patients with
giant uterine myoma.
Materials and methods. There examined the results of surgical treatment of 74
patients with a diagnosis of giant uterine myoma. Research conducted at the Department
of Gynecology and Intensive Therapy Odessa Regional Hospital in 2010-2016.
The average age of patients with uterine myoma was 48.31±5.65 years. Blood clotting
system was investigated using low-frequency pyezoelectric thromboelastography.
Patients were divided into two groups depending on the type of correction hemocoagulation
disorders. 35 patients of 1 group received in complex correction epidural
anesthesia at the level of L2-L3 7–12 ml of 0.5 % bupivacaine and 10 mL of 0.
5 % bupivacaine in the first postoperative day fractionally. Anticoagulant therapy
was bemiparin 2500 IU in the first post-operative day and for 7 days after. Antifibrinolytic
therapy in these patients has not been evaluated. 39 patients of second
group had complex correction which included epidural anesthesia at the level of
L2-L3 7–12 ml of 0.5 % bupivacaine and 10 mL of 0.5 % bupivacaine in the first
postoperative day fractionally. Anticoagulant therapy was bemiparin 2500 IU in
the first post-operative day and for 7 days after. Patients in this group was assigned
tranexamic acid for 30 minutes prior to surgery in a dose of 20 mg/kg, and followed
infusion — 5 mg/kg per hour for the first postoperative day.
