[Diagnosis and treatment of inferior vena cava thrombosis].

A total of 572 patients with acute thrombosis in deep veins of the inferior vena cava system were treated in the Department of Vascular Surgery. X-ray contrast retrograde iliocavography (XICG) revealed 96.5 % cases of iliocaval segment thrombosis. Signs of thromboembolism in pulmonary artery branches (TELA) were detected by angiopulmonography (APG) in 92.3% cases. Thrombectomy was undertaken in 62 (39.7%) of the patients, venous clipping or placation without thrombectomy were performed in 94 (60.3%) ones. All operated patients experienced regress of clinical symptoms of deep vein thrombosis in the absence of TELA and were discharged in good clinical condition. It is concluded that surgical techniques for the prevention of TELA should be chosen on an individual basis taking account of thrombus character and location detected by central duplex scanning, XICG and APG.

[Mutation frequencies of the thrombophilic state genes in Uzbekistan].

The prevalence of mutations of the genes of the coagulation factor V (G1691A), the coagulation factor II (G20210A), and of MTHFR (C677T) was investigated in patients with deep vein thrombosis of lower extremities (DVT) and healthy people of Uzbek nationality. The following prevalence of the mutant alleles among patients in Uzbekistan was revealed: for factor V Leiden--12,9%, prothrombin--4%, MTHFR--47,8%. The mutant allele of C677T gene (47,8%) was highly expressed in patients with DVT. It was revealed that the mutation of MTHFR gene was more common among female patients with DVT than in male patients with DVT. In Uzbek population the mutation G20210A of the prothrombin gene was detected rarely than the mutations of MTHFR and factor Leiden. The penetrance and the role of these mutations in the development of the thrombosis of deep veins were studied.

[Symptom-free phlebothrombosis and hereditary thrombophilia in patients with a skeletal injury].

The authors have studied the frequency of revealing phlebothrombosis of the system of the inferior vena cava (IVC) in the acute period of a mechanical injury by means of coloured duplex scanning (CDS). Formulated herein are both treatment policy and principles of prevention of thromboembolic complications in severe lesions of the locomotor system. Carried out was a screening sonographic examination of the IVC bed in a total of 137 injured people on days 3 and 7 after a skeletal wound. Of these, 24 patients who later on were diagnosed with phlebothrombosis signs underwent the molecular genetic testing of DNA by means of the polymerase chain reaction (PCR) in order to determine hereditary predisposition to thrombogenesis (genetically conditioned thrombophilia). It was found that the incidence rate of symptom-free thrombosis of the IVC bed in those presenting with fractures of pelvic bones and lower extremities amounted to 17.5%. As surgical prevention suggested herein is the authors' technique of IVC clipping.