ВЕНОЗНЫЙ ТРОМБОЭМБОЛИЗМ В ХИРУРГИЧЕСКОЙ И ТРАВМАТОЛОГИЧЕСКОЙ ПРАКТИКЕ. ОБЗОР ЛИТЕРАТУРЫ.
Введение: Венозные тромбоэмболии, является третьей ведущей причиной смерти во всем мире. Несмотря на широкое внимание к проблеме, коварство патологии заключается в низкой диагностической ценности предварительных тестов, проведенных до начала какой-либо патологии (онкология, хирургическое вмешательство, роды и другие), низким эффектом от проведения неспецифических мероприятий, высоким процентом летальности и осложнений в ближайшие и отдаленные сроки. Длительные и массивные хирургические вмешательства и травматологические операции являются одной из ведущих причин развития венозных тромбозов и летальности у пациентов молодого и среднего возраста, при отсутствии других ведущих причин.
Цель: поиск современных источников информации о механизмах развития венозных тромбозов, их профилактики и лечении при хирургических и травматологических вмешательствах.
Стратегия поиска: Нами были изучены результаты оригинальных исследований, клинических исследований, в том числе контролируемых и рандомизированных, систематических обзоров и мета-анализов, полученные в результате отклика на ключевые слова: «venous thromboembolism», «venous thromboembolism in surgeon», «venous thromboembolism in traumatology», «prevention of venous thromboembolism», «treatment of venous thromboembolism», «outcomes of venous thromboembolism» индексируемые в базах данных PubMed, Medline, Scopus, Trip Database. Глубина поиска составила 7 лет. Критериями включения являлись статьи, освещающие вопросы современной диагностики тромбоэмболий в хирургической практике. Исключены - освещающие тромбоэмболии при акушерской патологии, онкологии и заболеваниях сердечно-сосудистой системы. Поиск по ключевым словам и основным критериям включения и исключения выдал результаты 782 работ. В окончательный анализ включены 59 из них.
Результаты: Современные руководства по профилактике и лечению венозных тромбоэмболий, рассмативают в качестве претестовой шкальную оценку, которая проводится на различных шкалах и является основой для выявления групп пациентов, с повышенным риском тромбообразования. Отмечается, что тесты, популярные десятилетие назад, при оценке временем потеряли свою актуальность и не должны выступать как четкие критерии начавшегося эпизода тромбоза. Подходы к медикаментозной терапии претерпели изменения с внедрением в практику новых видов лекарственных веществ.
Сауле А. Исаханова, https://orcid.org/0000-0001-5231-3891
Кафедра госпитальной терапии, НАО «Медицинский университет Семей»,
г. Семей, Республика Казахстан
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Исаханова С.А. Венозный тромбоэмболизм в хирургической и травматологической практике. Обзор литературы. // Наука и Здравоохранение. 2020. 3 (Т.22). С. 55-66. doi:10.34689/SH.2020.22.3.008Похожие публикации:
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