EFFECT OF THE LOW-MOLECULAR HEPARIN FRAGM IN ON HEMOSTASIS IN PATIENTS WITH ALIMENTARY-CONSTITUTIONAL OBESITY

The authors conducted comparative study of the hemostasis indices befo re and in the immediate period after operation for formation of a smal l stomach in 31 patients with stage III-IV alimentary-constitutional o besity, in 50 patients without obesity who underwent operation on the stomach, and in 15 volunteers. Nonspecific prevention of thrombogenesi s was performed in all patients with normal weight and those with obes ity. Patients with obesity were given in addition specific thrombogene sis prevention with nonfractionated heparin (group I) and fractionated low-molecular heparin-fragmin produced by KABI (groups II and III). S tudy of the parameters of the hemostasis system in the postoperative p eriod showed nonspecific prevention of thrombogenesis to be sufficient to reduce the risk of pulmonary artery phlebothrombosis and embolism in most patients without obesity. In patients with obesity the probabi lity of phlebothrombosis and thromboembolism is much higher, in view o f which they must be given heparin in addition to nonspecific preventi on. Fragmin, as an agent for thrombosis prevention, has certain advant ages over nonfractionated heparin and should be used more frequently i n clinical practice in patients of the risk group, e. g. with patholog ical obesity, in a dose no less than 100 U/kg. With the use of fragmin laboratory control before each injection is not needed. Administratio n of nonfractionated and fractionated heparins must be combined with b andaging of the lower limbs and other measures of nonspecific preventi on of thrombogenesis.