NEW OPPORTUNITIES FOR PREVENTION OF CLOTTING COMPLICATIONS AFTER ARTHROPLASTY OF LARGE JOINTS

160 patients who underwent the endoprosthesis replacement of coxofemoral, knee, humeral and elbow joints are examined. In study group (n = 80) in 30 minutes prior to operation and in 4 hours after its completion Tranexam was entered on 250 mg intravenously. In 10?12 hours after the end of operation (onset of stabile hemostasis) all patients of this group received Pradaxa on 220 mg with the subsequent its application of 1 times in day on 220 mg. In control group (n = 80) in 12 hours prior to operation Fraxiparine was entered (hypodermically with 0,3?0,4 ml with the subsequent intake on 1 time in day during the postoperative period). The volume of intraoperative and postoperative blood loss, as well as dynamics of hematologic indicators are determined. The total of the thromboembolic complications are estimated. Besides, in study group the wound drainage was carried out by CellTrans system from the subsequent refusion of blood, and in control group the wound drainage was carried out by usual PVC by drainages with active aspiration of contents, without refusion of blood. It is established that complex application in the early postoperative period of tranexamic acid, Pradaxa and also the wound drainage by CellTrans systems with the postoperative refusion of blood allowed more than 40% reduction in the volume of blood loss at all investigation phases; the general blood loss in study group made 585,4 ± 124,2 ml, in control group it made 959,8 ± 178.3 ml. The offered approach is an effective and safe prophylactic of the thromboembolic complications and bleedings in the early postoperative period after operations of endoprosthesis replacement of large joints.