И.С. Романова, И.Н. Кожанова, О.Ф. Кардаш, С.А. Мацкевич, В.В. Сиренко, В.Я. Хрыщанович, Н.В. Климчук, Н.В. Кулешов, И.А. Козич, А.А. Пичугина, И.В. Смирнова, Т.А. Чак, А.А. Королева
Учреждение образования «Белорусский государственный медицинский университет», Минск, Республика Беларусь1 Государственное учреждение здравоохранения «4-я городская клиническая больница им. Н. Е. Савченко», Минск, Республика Беларусь2
В настоящее время артериальные и венозные тромбозы являются одними из ведущих причин заболеваемости и смертности. Антикоагулянтная терапия относится к одному из наиболее востребованных в практической медицине подходов в лечении и профилактике тромботических состояний. В статье представлены наиболее часто применяемые в клинической практике антикоагулянты прямого действия и их сравнительная клинико-фармакологическая характеристика. Приведены основные положения рекомендаций по медицинской профилактикевенозных тромбозов с учетом характера хирургических мероприятий и факторов риска пациента. Приведены особенности использования низкомолекулярных гепаринов и нефракционированного гепарина
на фоне проведения регионарной анестезии. Представлены алгоритмы прерывания антитромботической терапии при плановых и неотложных оперативных вмешательствах
ключевые слова: антикоагулянты, венозные тромбозы, гепарины, профилактика венозных тромбоэмболических осложнений,
для цитирования: И.С. Романова, И.Н. Кожанова, О.Ф. Кардаш, С.А. Мацкевич, В.В. Сиренко, В.Я. Хрыщанович, Н.В. Климчук, Н.В. Кулешов, И.А. Козич, А.А. Пичугина, И.В. Смирнова, Т.А. Чак, А.А. Королева. Профилактика венозных тромбозов в хирургической практике. Неотложная кардиология и кардиоваскулярные риски, 2024, Т. 8, № 1, С. 2073–2085.
PREVENTION OF VENOUS THROMBOSIS IN SURGICAL PRACTICE
I. Romanova1 , I. Kozhanova1 , O. Kardash1 , S. Mackevich1 , V. Sirenko2 , V. Hryshchanovich , N. Klimchuk2 , N. Kuleshov2 , I. Kozich2 , A. Pichugina2 , I. Smirnova2 , T. Chak1 , А. Koroleva1
Currently, arterial and venous thrombosis are among the leading causes
of morbidity and mortality. Anticoagulant therapy is one of the most
popular approaches in practical medicine in the treatment and prevention
of thrombotic conditions. The article presents the most commonly used
direct-acting anticoagulants in clinical practice and their comparative clinical
and pharmacological characteristics. The main recommendations for medical prevention of venous thrombosis are provided, taking into account the nature
of surgical procedures and patient risk factors. The features of the use
of low molecular weight heparins and unfractionated heparin against the
background of regional anesthesia are given. Algorithms for interrupting
antithrombotic therapy during planned and emergency surgical interventions are presented.
keywords: anticoagulants, venous thrombosis, heparins, prevention of venous thromboembolic complications, Caprini scale, surgery
for references: I. Romanova, I. Kozhanova, O. Kardash, S. Mackevich, V. Sirenko, V. Hryshchanovich, N. Klimchuk, N. Kuleshov, I. Kozich, A. Pichugina, I. Smirnova, T. Chak, А. Koroleva. Prevention of venous thrombosis in surgical practice
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