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Early and remote results of treatment of deep vein thrombosis in the inferior vena cava system


Author: Sochircă Marcel
Degree:doctor of medicine
Speciality: 14.00.27 - Surgery
Year:2020
Scientific adviser: Evghenii Guţu
doctor habilitat, professor
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 22 January, 2020 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document1.88 Mb / in romanian

Thesis

CZU 616.146-005.6-08(043.2)

Adobe PDF document 3.78 Mb / in romanian
183 pages


Keywords

tromboza venelor profunde, sindrom posttrombotic, trombembolia arterei pulmonare, tromb flotant, tratament anticoagulant, trombectomie venoasă. Scopul lucrării: Ameliorarea rezultatelor tratamentului pacienţilor cu tromboza venelor profunde în sistemul venei cave inferioare

Summary

Structure: Introduction, 5 chapters, conclusions and recommendations, bibliography with 183 sources, 4 annexes, 159 pages of main text, 23 figures, 23 charts. The obtained results were published in 27 scientific works.

Aim of the study: Improvement of the results of treatment of patients with deep vein thrombosis in the inferior vena cava system.

Objectives of the study: Revealing factors with potential impact on remote results after deep vein thrombosis of the lower extremities; study of clinical-hemodynamic peculiarities of the evolution of deep vein thrombosis depending on the type, speed of starting and duration of anticoagulant treatment; highlighting the impact of regime of activity of the patient and the effect of concomitant medication and compressive therapy on treatment outcomes; and comparative analysis of the efficacy and safety of conservative and surgical treatment in patients with free-floating thrombus.

Novelty and scientific originality: It has been identified, that surgical venous interruption for prophylaxis of pulmonary embolism in carefully selected cases, are a justified alternative option of treatment. It was determined that in order to obtain the full recanalization of veins the minimal duration of anticoagulant therapy in deep vein thrombosis of the lower limbs should be extended to more than 6 months. It was shown that in order to reduce the frequency of severe postthrombotic syndrome anticoagulant treatment for deep vein thrombosis of the lower extremities should be started as soon as possible.

The scientific problem resolved: Have been optimized therapeutic tactics and have been identified the measures to improve the remote outcome of the treatment of deep vein thrombosis.

Theoretical significance: Have been identified the causes of unfavorable remote outcome of the treatment of deep vein thrombosis, as well as measures to improve the therapeutic results. Applicative significance of the study: Has been improved the therapeutic regimen, and developed measures to improve the remote results of complex treatment of deep vein thrombosis.

Implementation of scientific results: at the meeting of the Association of Surgeons “Nicolae Anestiadi” of the Republic of Moldova with the aim of continuous training of surgeons, in the didactic process for students and medical residents used in the Department of General Surgery and Semiology No.3 of State Medical and Pharmaceutical University “Nicolae Testemitanu”, in the current practice of the Departments of Surgery of Healthcare Public Institution Municipal Clinical Hospital No.1, Municipal Clinical Hospital No.3 „Sfânta Treime”, as well as in the Departments of Surgery of Central Clinical Military Hospital.