Л.Н. Гавриленко, И.С. Романова, И.Н. Кожанова, О.Г. Садовская, А.Е. Барановский
Белорусский государственный медицинский университет,4-я городская клиническая больница им. Н.Е.Савченко, г. Минск, 5-я городская клиническая больница, г. Минск
Смертность от венозных тромбоэмболических осложнений (ВТЭО) составляет около 25000 смертей в год в Великобритании. В США около трети из 150-200 тыс. смертей, ассоциированных с тромбоэмболиями, происходит после операции. Риск ВТЭО у пациентов нейрохирургического профиля широко варьирует в зависимости от вида хирургического вмешательства, состояния пациента, наличия сопутствующей патологии, использования различных методов тромбопрофилактики. Особенности пациентов нейрохирургического профиля (высокая частота гиповолемии и гемоконцентрации, распространенность параличей и парезов, использование высоких доз глюкокортикоидов, большая длительность оперативных вмешательств), высокий риск кровотечений при использовании фармакологических методов профилактики, а также отсутствие достаточного количества исследований высокого качества требуют выработки единого подхода к тромбопрофилактике в нейрохирургии. В данной статье представлена стратегия профилактики ВТЭО у пациентов нейрохирургического профиля, разработанная авторами на основании актуальных международных рекомендаций.
ключевые слова: венозные тромбоэмболические осложнения, профилактика, нейрохирургия
для цитирования: Л.Н. Гавриленко, И.С. Романова, И.Н. Кожанова, О.Г. Садовская, А.Е. Барановский. Стратегия оценки рисков и профилактики тромбоэмболических осложнений у пациентов нейрохирургического профиля. Неотложная кардиология и кардиоваскулярные риски, 2020, Т. 4, № 1, С. 909–916
Risk assessment and venous thromboembolism prophylaxis strategy in neurosurgical patients
L.N. Gavrilenko, I.S. Romanova, I.N. Kozhanova, O.G. Sadovskaya, A.E. Baranovsky
Venous thromboembolism (VTE) causes 25,000 in-hospital deaths every year in the United Kingdom. Approximately one-third of the total of 150,000 to 200,000 of VTE-related deaths per year in the United States occur following surgery. The VTE risk varies widely in neurosurgical patients depending on the type of intervention, the patient’s condition, comorbidity, and methods of thromboprophylaxis used. Neurosurgical patients’ characteristics (high prevalence of hypovolemia and hemoconcentration, paralysis and paresis, the use of high doses of glucocorticoids, the long duration of surgical interventions), high bleeding risk associated with pharmacological prophylaxis, and relatively few high-quality studies require development of a uniform decision-making approach regarding thromboprophylaxis in neurosurgery. This article presents a VTE prophylaxis strategy in neurosurgical patients developed on the basis of the latest international guidelines.
keywords: venous thromboembolism, prophylaxis, neurosurgery
for references: L.N. Gavrilenko, I.S. Romanova, I.N. Kozhanova, O.G. Sadovskaya, A.E. Baranovsky. Risk assessment and venous thromboembolism prophylaxis strategy in neurosurgical patients. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2020, vol. 4, no. 1, pp. 909–916
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