Authors
Masljakov V.V. 1, Urjadov S.E.2, Kapralov S.V.1, Bahaev A.D.3
1 Saratov State Medical University named after V.I. Razumovsky, Saratov
2 Medical University «Reaviz», Saratov
3 Saratov City Clinical Hospital No. 1 named after Yu.Ya. Gordeeva, Saratov
Abstract
The purpose of the study. Perform analysis of certain parameters of peripheral blood, hemoreology, vascular-platelet unit of hemostasis system in patients of different age groups with spleen injuries in the nearest postoperative period depending on performed surgery.
Materials and methods. The work is based on an analysis of the course of the nearest postoperative period of 120 patients admitted with closed abdominal injuries, accompanied by a rupture of the spleen. Of these, 68 patients with spleen injuries made up the main group, whose age ranged from 60 to 89 years. The comparison group included 52 young and middle-aged patients. The examined patients were examined for peripheral blood, hemoreology, vascular-platelet link of the hemostasis system.
Results. The presented results show that in elderly and senile patients after splenectomy, changes in peripheral blood, hemoreology, vascular-platelet units of the hemostasis system are less pronounced than after splenectomy with autoylientransplantation. At the same time, in the group of young and middle-aged patients, more pronounced changes were noted after splenectomy. There has been a significant, statistically significant decrease in red blood cell count, hemoglobin count, and hematocrit count. In addition, in the near postoperative period there is an increase in blood viscosity at all shear rates. The antithrombogenic properties of the vascular endothelium are heterogeneous: against the background of a decrease in vascular endothelial thromboresistivity, there is an increase in fibrinolytic activity, accompanied, however, by a decrease in the reserves of the tissue activator plasminogen in the vascular wall and a decrease in its secretion into the bloodstream. The presented data indicate that biologically active substances are produced in the spleen tissue to facilitate the release of tissue plasminogen activators formed in the endothelium into the bloodstream, which in turn can lead to the development of intravascular thrombosis in these patients.
Keywords: spleen injury, older age group, hemoreology, vascular-platelet link of hemostasis system, autolientransplantation.
References
1. Smoljar AN. Zakrytaja travma zhivota. Povrezhdenija selezenki. Closed abdominal injury. Spleen injuries. Part 2. Surgery Journal named after N.I. Pirogov. 2016; (2): 4-10. (In Russ.)
2. Rumer V.B., Arablinskij A.V. CT semiotics of traumatic and non-traumatic spleen injuries. Medical imaging. 2021; 5(2): 50-62. (In Russ.) doi: 10.24835/1607-0763-946.
3. Gavrishhuk JaV, Manukovskij VA, Tulupov AN, Demko AE, Kolchanov EA, Savello VE, Kandyba DV, Kazhanov IV, Platonov SA, Kazankin AS. Possibilities of conservative and minimally invasive organ-preserving treatment of spleen injuries in closed abdominal injuries in adults. I.I. Grekov Journal of Surgery. 2021; 180(4): 18-27. (In Russ.)]doi: 10.24884/0042-4625-2021-180-4-18-27.
4. Masljakov VB, Urjadov SE, Gorbelik VR, Allahjarov TCh, Kulikov SA, Shihmagomedov MA, Aristova IS. Metalloproteinases in predicting the course of the nearest postoperative period with closed spleen injuries. Bulletin of the Medical Institute «REAVIZ». Rehabilitation, Doctor and Health. 2020; (1): 57-65. (In Russ.)]
5. Pinchuk PV, Leonov SV, Levandrovskaja IA. Experience in using finite element analysis to predict and diagnose spleen injuries. Military Medical Journal. 2021; 342(7): 11-14. (In Russ.)
6. Vojnovskij AE, Indejkin AV, Koltovich AP, Shabalin AJu, Kukunchikov AA, Gubskaja NV. Surgical tactics for closed abdominal injuries with isolated spleen injury. Ministry of the Interior Medical Gazette. 2010; 2(45): 4-10. (In Russ.)
7. Smol’kina AV, Makarov SV, Evseev RM, Halitova NI. Features of patient management in combined trauma with spleen rupture. Bulletin of the Medical Institute «REAVIZ»: rehabilitation, doctor and health. 2019; 3(39): 137-140. (In Russ.)
8. Masljakov VV, Urjadov SE, Tabunkov A.P. Features of the immune system in elderly patients after splenectomy in the near postoperative period. Russian Medical and Biological Bulletin named after academician I.P. Pavlov. 2015; 1: 115-119. (In Russ).
9. Masljakov VV, Urjadov SE, Tabunkov AP. Condition of the vascular-platelet unit of the hemostasis system in elderly patients after splenectomy in the near postoperative period. Bulletin of Altai Science 2014; 4: 288-292. (In Russ).
10. Masljakov VV, Barsukov VG, Tabunkov AP. Features of vascular wall endothelial functional state in elderly patients after splenectomy. Yakutsk Medical Journal. 2014; 4: 14-17. (In Russ).
