ROLE OF INDICATORS OF THE HEMOSTASIS IN PATHOGENESIS ESOPHAGEAL AND GASTRIC BLEEDINGS AT PORTAL HYPERTENSIA AT CHILDREN
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Abstract
The article analyzes the examination of 67 children with extrahepatic block of portal hypertension. To provide evaluation of hemostasis all children were determined in coagulative, fiber thrombocytic hemostasis, the intensity of fibrinolysis and physiologic anticoagulants. The patients were divided into two groups, one of them is with escape of blood from the esophageal veins, others are not. The parameters of the extended coagulogram allowed to characterize the activity of natural anticoagulants, fibrinolysis system, coagulation factors, aggregative activity of platelets (thrombocytes).
Most patients from both groups were revealed a higher activity, an increased concentration of Willebrand factor, an impaired aggregative capability of platelets with ADP and ristocetin. There were less frequent changes such as an increase in the activity of factor VIII and in the concentration of D-dimer, inhibition of XII-dependent fibrinolysis. As the result of the correction of hemostasis in hemostatic indicators were observed chronometric normocoagulation with a slight deficit of factors that form prothrombinase combined with a slight increase the blood plates count with their normal aggregation function and mild endotheliosis, and with a normal level of progressive antithrombins.
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Author Biographies
Вадим Александрович Дударев,
candidate of medical science, docent, chair of pediatric surgery with course of post graduate educationМарина Юрьевна Галактионова,
Galaktionova Marina Yurievna
MD, PhD, professor, head of department of polyclinic pediatrics and propaedeutics of children’s diseases.
She has been working as the Principal Scientific Researcher at the Clinical Department of Somatic and Mental Wellbeing in Paediatrics since 1998. She was working as an Academic Secretary at the State Medical Research Institute for Northern Problems, Siberian Division of Russian Academy of Medical Sciences (February, 2001 – June, 2005).
Her priorities are: the studying of the development of the heart rhythm disorder and the cardiac conduction disease in children with the effect of of perinatal pathology of the CNS and syndrome of connective tissue dysplasia; the assessment of heart rate variability, central and cerebral hemodynamics indicators, vegetal homeostasis in children for the detection of the adaptational capacity of the cardiovascular system; the development of diagnostic protocols for identification and technologies of rehabilitation in children and adolescents taking into account the individual-typological approach with the aim of assessment for the health status.
She is an author of 327 scientific works, including 34 studying manuals, 4 monographs, 2 invention patents.
Under her supervision there were written one Candidate thesis, she also assisted in writing several sections of two dissertations on the study of clinical and functional characteristics of cardiac rhythm and conduction in children with different somatotype and small congenital malformations of the heart.
She is a Professor of the Russian Academy of Science since 2001, a member of the Russian Society of Cardiology and the Union of Pediatricians of Russia (the author of the Hymn of the organization). She is also a member of the “Pediatrics. Pediatric surgery. Genetics” Problem Commission of Krasnoyarsk State Medical University.
The pediatrician of the highest qualification category.Article Details
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The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
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References
Drozdov AV. Algorithm of diagnostics and methods of surgical correction of extrahepatic form of portal hypertension in children: cand. med. sci. abstracts dis. M., 2002. 24 p. Russian (Дроздов А.В. Алгоритм диагностики и методы хирургической коррекции внепеченочной формы портальной гипертензии у детей: автореф. дис. … канд. мед. наук. М., 2002. 24 с.)
Voronkova EV, Lukina EA et al. Hemostasis disorders in patients with portal thrombosis. Clinical haemostasiology and hemorheology in cardiovascular surgery: Proceedings of the Third All-Russian Scientific Conference. M., 2007. P. 53. Russian (Воронкова Е.В., Лукина Е.А. и соавт. Нарушения гемостаза у больных с портальными тромбозами //Клиническая гемостазиология и гемореология в сердечно-сосудистой хирургии: Матер. 3-й Всерос. науч. конф. М., 2007. С. 53)
Mansurov H.H. Portal hypertension: pathophysiology, classification, diagnosis and management of patients. The Russian Journal of Gastroenterology, Hepatology, Coloproctology. 1997; (3): 69-72. Russian (Мансуров Х.Х. Портальная гипертензия: патофизиология, классификация, диагностика и тактика ведения больных //Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 1997. № 3. С. 69-72)
Scherzinger AG. Tactics for acute bleeding from varicose veins of the esophagus and stomach. The Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2001; (3): 40-42. Russian (Шерцингер А.Г. Тактика при острых кровотечениях из варикозно расширенных вен пищевода и желудка //Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2001. № 3. С. 40-42)
Chin AC, Thow F, Superina RA. Previous portal hypertension surgery negatively affects results of mesenteric to left portal vein bypass. J. Pediat. Surg. 2008; 43(1): 114-119
El-Rifai N, Mention K, Guimber D, et al Gastropathy and gastritis in children with portal hypertension. J. Pediat. Gastroenterol. Nutr. 2007; 45(1): 137-40
Lukina E., Sysoeva E. Genetic polymorphism of hemocoagulation factors in patients with prehepatic portal hypertension. Abstract book of the Falk Symposium № 161, Future Perspectives in Gastroenterology. Germany, 2007. Abstr. N 29