Sergeeva A.M., Trefilov A.A.
Republican Children's Hospital, City Children's Hospital № 3, Cheboksary, Russia.
Introduction. As a result, an integrated approach to the treatment of acute leukemia appeared positive changes in the outcomes of treatment, thus revise their attitude to this disease: the absolutely fatal to potentially curable. Central venous catheterization - a necessary attribute of all stages of treatment. In case of accidental damage to an artery or vein puncture through-there is a high risk of hemorrhagic complications in the form of violations of plasma and platelet hemostasis. Depending on the location, the massiveness of damage and the competence of hemostatic mechanisms vascular injury may be accompanied by the appearance of a hematoma, external bleeding, hemothorax and gemomediastinum.
Purpose. Determine the place of ultrasound navigation prophylactic prosthetic perverse components of hemostasis in the algorithm of venous catheterization in children with acute leukemia.
Materials and methods. A comparative analysis of hemorrhagic complications during central venous catheterization in 70 patients with acute leukemia who are treated at three major hospitals of the Volga region. The patients were divided into two groups. In the first group (40 children) catheterization was performed under ultrasound-guide, visualization of congenital variants of the location and size of vessels. In the second group (30 children) in addition to the application of ultrasonic navigation injected recombinant activated factor VII clotting - a highly hemostatic, which affects only the place of injury of the vascular wall without causing systemic activation of coagulation. The dynamics was carried ultrasound visualization to prevent hematoma and determine the level of hemoglobin and red blood cells.
Results. Prior to the application of ultrasonic navigation with the introduction of recombinant activated factor VII clotting hemorrhagic complications during central venous catheterization in children with acute leukemia have reached 53%. The first group of hemorrhagic complications were registered in 3 patients (8%). In the second group were no complications.
Conclusion. Prophylactic use of recombinant activated factor VII clotting with ultrasound-guide minimizes the risk of hemorrhagic complications in catheterization of veins in children with acute leukemia.