[Prevention of postoperative phlebothrombosis of the legs using low-dose heparin in urologic patients]

Deep vein thrombosis of low extremities is the commonest complication in postsurgical urology. Difficult for diagnosis it induces thromboembolism of pulmonary artery contributing from 11.1 to 66 per cent to the rate of total postsurgical mortality. Possibility of solving the problem depends strongly on the development of efficient technique of phlebothrombosis prevention. The paper deals with the corresponding research conducted in 202 urologic patients aged from 40 to 90 years. The control group (108 persons) was subjected to routine nonspecific methods of thromboembolism prevention. The research group (94 patients) was additionally prone to the treatment with low dosages of heparin. The effect of the treatment was assessed with 125I-fibrinogen radionuclide test. Low-dosage heparin treatment resulted in a 3.3-fold decrease in the number of patients who developed postsurgery phlebothrombosis of low extremities. Incidence of thrombosis in them was 4.2-fold lower. Besides, there was a reduction in bilateral and macrofocal thrombosis incidence (11 and 11.5 times as less, respectively). The effect of the chemotherapy closely correlated with the pattern of surgical intervention and the dosage of the drug used. Low dosages of heparin (10,000 U per 24 hrs) administered to the patients with adenectomized prostate resulted in a 2.1-fold decrease in the number of those who developed deep venous thromboses of low extremities and a 3.4-fold decrease in the number of thrombosed extremities as low-dosage heparin treatment significantly influenced the incidence of bilateral thrombosis. When used as 15,000 U per 24 hrs in those patients who were exposed to lithotomy or nephrectomy the drug led to a 5-fold decrease in the incidence of phlebothrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)