Тромбоз, гемостаз и реология

Tromboz, Gemostaz I Reologiya
scientific and practical journal

ISSN 2078–1008 (Print); ISSN 2687-1483 (online)
2024, Original papers
2024

Hemostasis in children with surgical oral and maxillofacial pathology: 616.151.5:617.51/53

Original papers
Published 2024-10-11
Dana E. Pavlova
Morozovskaya Children’s City Clinical Hospital, Moscow Healthcare Department; 1/9 4th Dobryninskiy Pereulok, Moscow 119049, Russia;
ГБУЗ «Морозовская детская городская клиническая больница Департамента здравоохранения города Москвы»; Россия, 119049 Москва, 4‐й Добрынинский переулок, 1/9;
Nikolai P. Leonov
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation; 1 Samora Machel Str., Moscow 117997, Russia;
ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии имени Дмитрия Рогачева» Министерства здравоохранения Российской Федерации; Россия, 117997 Москва, ул. Саморы Машела, 1;
Pavel G. Madonov
Novosibirsk State Medical University, Ministry of Health of the Russian Federation; 52 Krasny Prospekt, Novosibirsk 630091, Russia;
ФГБОУ ВО «Новосибирский государственный медицинский университет» Министерства здравоохранения Российской Федерации; Россия, 630091 Новосибирск, Красный проспект, 52;
Pavel E. Trakhtman
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation; 1 Samora Machel Str., Moscow 117997, Russia;
ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии имени Дмитрия Рогачева» Министерства здравоохранения Российской Федерации; Россия, 117997 Москва, ул. Саморы Машела, 1;
Svetlana V. Iamatina
Children’s State Hospital of St. Vladimir, Moscow Healthcare Department; 1/3 Rubtsovsko‐Dvortsovaya Str., Moscow 107014, Russia;
ГБУЗ «Детская городская клиническая больница святого Владимира Департамента здравоохранения города Москвы»; Россия, 107014 Москва, Рубцовско‐Дворцовая ул., 1/3;
Elena A. Spiridonova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation; 1 Samora Machel Str., Moscow 117997, Russia; A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation; 20/1 Delegatskaya Str., Moscow 127473, Russia;
ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии имени Дмитрия Рогачева» Министерства здравоохранения Российской Федерации; Россия, 117997 Москва, ул. Саморы Машела, 1; ФГБОУ ВО «Московский государственный медико‐стоматологический университет имени А.И. Евдокимова» Министерства здравоохранения Российской Федерации, 127473, Москва, Делегатская ул., 20/1;
Nikolai S. Grachev
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation; 1 Samora Machel Str., Moscow 117997, Russia;
ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии имени Дмитрия Рогачева» Министерства здравоохранения Российской Федерации; Россия, 117997 Москва, ул. Саморы Машела, 1;
Andrey Yu. Bulanov
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department; 3 Bolshaya Sukharevskaya Ploshchad, Moscow 129010, Russia
ГБУЗ «Научно‐исследовательский институт скорой помощи имени Н.В. Склифосовского Департамента здравоохранения города Москвы»; Россия, 129010 Москва, Большая Сухаревская площадь, 3

Keywords

thrombosis
local intravascular coagulopathy
vascular malformations
surgical oral and maxillofacial pathology
thromboelastography
thrombodynamics
hemostasis
children
  Full Text

Abstract

Summary. Introduction. Children with oral and maxillofacial pathologies are at risk of local thrombotic events, which exacerbate the outcomes of surgical treatment. Aim: to assess the hemostasis in children with surgical oral and maxillofacial pathology using both conventional and integral methods. Materials and Methods. A retrospective observational study was conducted on 271 children with surgical oral and maxillofacial pathology. Prior to surgical intervention, demographic, clinical and laboratory data were collected as well as hemostasis studies were performed. The patients were divided into four groups: vascular malformations (n=115), inflammatory (n=66), hemangiomas (n=16), and controls (n=47). Results. The incidence of local thrombotic events in patients with vascular and inflammatory diseases was higher (padj = 0.001 and padj < 0.001, respectively) compared with the control group and amounted to 20% and 31.8%, respectively. The median hospital stay for children with thrombotic events was 24 [16; 33] days, while the median stay for those without thrombotic events was 12 [8; 19] days (p < 0.0001). In cases of vascular malformations and inflammatory conditions, thrombodynamics revealed spontaneous blood clots in the samples. The growth rate and the size of the blood clots exceeded the reference values. Conclusion. It is imperative to conduct comprehensive monitoring of hemostasis parameters. Conventional blood clotting tests are inadequate for detection of early signs of hypercoagulability. Integral methods for monitoring hemostasis are effective for the early diagnosis of thrombotic events. The thrombodynamic test better reveals the hypercoagulation potential hidden from other methods at the preoperative stage. Regional thrombotic events in surgical oral and maxillofacial pathology have been demonstrated to result in a doubling of the length of hospital stay.

For citation: Pavlova D.E., Leonov N.P., Madonov P.G., Trakhtman P.E., Iamatina S.V., Spiridonova E.A., Grachev N.S., Bulanov A.Y. Hemostasis in children with surgical oral and maxillofacial pathology. Tromboz, gemostaz i reologiya. 2024;(3):39–50. (In Russ.).

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