[The diagnosis and correction of hemostatic system disorders during surgical coagulopathic hemorrhages in cancer patients].

The hemostasis system was examined before surgery, during the principal stages of the operative intervention, and in the early postoperative period in 280 patients with various malignant tumors. The volume of intraoperative blood loss varied from 280 to 14,000 ml. The studies revealed that the main factor causing the most profound disorders in the hemostasis system which lead to the development of grave coagulopathic hemorrhages is blood loss due to surgical trauma. Coagulopathic bleedings most frequently develop in case of at least a 3000 ml blood loss and course as different variants and stages of the syndrome of disseminated intravascular coagulation (DIC) or hemodilution coagulopathy. Massive blood loss was found to involve primarily damage of the platelet component of the hemostasis system, thrombocytopenia being paralleled by a drastic reduction of the aggregability of these cells, this, in turn, increasing bleeding from small vessels. Laboratory signs of acute DIC diagnosed during surgery anticipate its clinical manifestation. Working classification of operative bleedings and rapid methods for their diagnosis have been developed.