Natural and medical sciences

2020 Issue №2

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Rheological properties of blood and hemostasis of the stab wounds of the heart



The authors try to characterize changes in viscosities of blood and throm­boresistance of vascular endothelium after stab wounds of heart. To achieve the goal, the indicators of microblood circulation were studied in 34 patients. All patients were divided into two groups: the first group of 17 people has been operated for the wounds of heart with the thoracotomy, suturing heart wounds and the pleural cavity drainage. The second group of 17 patients had stab wounds of the chest, they underwent primary surgical treatment of wounds, drainage of the pleural cavity. A study of the patient’s blood coagula­tion capacity, the examination of markers of intravascular coagulation of the blood, the level of D-dimer, and the viscosity of the blood were made. The study established that the heart wounds are characterized by disturbances of the microcirculatory bed in the nearest post-surgery term. At the same time the maximum changes are revealed for 5—7 post-surgery days when all stud­ied indicators showed some changes of, in particular a coagulative hemostasis system got more activated which was manifested by shortening of blood plas­ma recalcification time, thrombin time, at the same time, the final process of blood coagulation was activated, which resulted in an increase in the level of fibrin in the blood. In addition, this period was characterized by a decrease in the activity of antithrombin III and an increase in HAEM-kallikrein-dependent fibrinolysis as well as the increased level of D-dimer in the blood, the increase of the viscosity of blood at all shear rates, in addition, in this peri­od there was a decline in anticoagulant and fibrinolytic activity of the endo­thelium, which can be regarded as a manifestation of DIC. The complete re­covery of the studied indicators occurred on 17—19 postoperative days. Heart wounds lead to a change in the microcirculation, the maximum of which falls on 5—7 post-surgery days. Patients with heart wounds can be referred to as thrombotic for 5—7 post-surgery days.