[Ortho] профилактика тромбозов при иммобилизации

[Александр Ларионов]

п║п©п╟я│п╦п╠п╬, п░п╫п╢я─п╣п╧. п≤п╫я┌п╣я─п╣я│п╫я▀п╣ п╢п╟п╫п╫я▀п╣. п╔п╬я┌я▐, п╠я▀п╡п╟п╣я┌, я│п╪п╣я─я┌я▄ п╬я┌ п╒п╜п⌡п░ я│п╩я┐я┤п╟п╣я┌я│я▐
п╦ п©я─п╦ п©п╬п╩п╫п╬я├п╣п╫п╫п╬п╧ п╣п╣ п©я─п╬я└п╦п╩п╟п╨я┌п╦п╨п╣. :(

я┤я┌, 4 п╬п╨я┌. 2018 пЁ. п╡ 20:53, Sereda Andrey <orthoforum на weborto.net>:

> п÷я─п╬я└п╦п╩п╟п╨я┌п╦п╨п╟ я┌я─п╬п╪п╠п╬я█п╪п╠п╬п╩п╦я┤п╣я│п╨п╦я┘ п╬я│п╩п╬п╤п╫п╣п╫п╦п╧ - я┤я─п╣п╥п╡я▀я┤п╟п╧п╫п╬ п╡п╟п╤п╫п╟, я┌п╟п╨ п╨п╟п╨
> п©п╬я─п╬п╧ п©п╬п╥п╡п╬п╩я▐п╣я┌ я│п©п╟я│я┌п╦ п╤п╦п╥п╫я▄. п╜я┌п╬ п╬я┤п╣п╡п╦п╢п╫п╬. п²п╬ п╩я▌п╠п╟я▐ п©п╬п©я▀я┌п╨п╟ п╡ п╪п╣п╢п╦я├п╦п╫п╣
> я│п╢п╣п╩п╟я┌я▄ я┤я┌п╬-я┌п╬ п╡я│п╣пЁп╢п╟ п╦п╪п╣п╣я┌ п╪п╦п╫я┐я│я▀. п▓ я┤п╟я│я┌п╫п╬я│я┌п╦, я└п╟я─п╪п╟п╨п╬п╩п╬пЁп╦я┤п╣я│п╨п╟я▐
> п©я─п╬я└п╦п╩п╟п╨я┌п╦п╨п╟ я┌я─п╬п╪п╠п╬я█п╪п╠п╬п╩п╦п╧ п╡я│п╣пЁп╢п╟ п╢п╬п╩п╤п╫п╟ я│п╬п╬я┌п╫п╬я│п╦я┌я▄я│я▐ п╫п╟ п©я─п╣п╢п╪п╣я┌
> я─п╦я│п╨/п©п╬п╩я▄п╥п╟ п╡ п╨п╩я▌я┤п╣ пЁп╣п╪п╬я─я─п╟пЁп╦я┤п╣я│п╨п╦я┘ п╬я│п╩п╬п╤п╫п╣п╫п╦п╧. п²п╦ пЁп╟я│я┌я─п╬п╦п╫я┌п╣я│я┌п╦п╫п╟п╩я▄п╫я▀п╣
> п╨я─п╬п╡п╬я┌п╣я┤п╣п╫п╦я▐, п╫п╦, я┌п╣п╪ п╠п╬п╩п╣п╣, пЁп╣п╪п╬я─я─п╟пЁп╦я┤п╣я│п╨п╦п╣ п╦п╫я│я┐п╩я▄я┌я▀, п╫п╦я┤я┐я┌я▄ п╫п╣ п╪п╣п╫п╣п╣
> п╬п©п╟я│п╫я▀, я┤п╣п╪ DVT/PE, п╦ п╦п╪п╣п╫п╫п╬ п╫п╟ я█я┌п╬п╪ я│п╬п╬я┌п╫п╬я┬п╣п╫п╦п╦ я─п╦я│п╨/п©п╬п╩я▄п╥п╟ я│я┌я─п╬я▐я┌я│я▐
> п╢п╦п╥п╟п╧п╫я▀ п©я─п╟п╨я┌п╦я┤п╣я│п╨п╦ п╡я│п╣я┘ п╦я│я│п╩п╣п╢п╬п╡п╟п╫п╦п╧ п©п╬ я┌п╣п╪п╣. п·п╢п╫п╟п╨п╬ п╣я│я┌я▄ п╦ п╢я─я┐пЁп╦п╣
> п╪п╦п╫я┐я│я▀. п▓ я┤п╟я│я┌п╫п╬я│я┌п╦, я┐п╤п╣ п╠п╬п╩п╣п╣ 6 п╩п╣я┌ п╨п╟п╨ п╥п╟п╪п╣я┤п╣п╫п╬, я┤я┌п╬ п╨я│п╟п╠п╟п╫я▀ п©п╬п╡я▀я┬п╟я▌я┌
> я─п╦я│п╨ п╦п╫я└п╣п╨я├п╦п╬п╫п╫я▀я┘ п╬я│п╩п╬п╤п╫п╣п╫п╦п╧ п©п╬я│п╩п╣ я█п╫п╢п╬п©я─п╬я┌п╣п╥п╦я─п╬п╡п╟п╫п╦я▐. п²п╬ п╪п╫п╣ п╫п╣
> п╦п╥п╡п╣я│я┌п╣п╫ п╫п╦ п╬п╢п╦п╫ я┌я─п╟п╧п╩ п©п╬ я█я└я└п╣п╨я┌п╦п╡п╫п╬я│я┌п╦ п╨я│п╟п╠п╟п╫п╬п╡, п╨п╬я┌п╬я─я▀п╧ п╠я▀ п╦п╥я┐я┤п╟п╩ п╦
> я█я┌п╬я┌ п╨п╬п╪п©п╬п╫п╣п╫я┌. п╜я┌п╟ п©я─п╬п╠п╩п╣п╪п╟ п╡п╬п╩п╫я┐п╣я┌ п╡п╣п╢я▄ я┌п╬п╩я▄п╨п╬ я┘п╦я─я┐я─пЁп╬п╡, я┌я─п╟п╡п╪п╟я┌п╬п╩п╬пЁп╬п╡
> п╦ п©п╟я├п╦п╣п╫я┌п╟, п╨п╬я┌п╬я─п╬п╪я┐ я│п╩п╬п╤п╫п╬ п╤п╦я┌я▄ я│ п©п╬я┌п╣я─я▐п╫п╫я▀п╪
> я█п╫п╢п╬п©я─п╬я┌п╣п╥п╬п╪, п╫п╬ п╫п╣ п╡п╬п╩п╫я┐п╣я┌ п╢я─я┐пЁп╦п╣ я│я┌п╬я─п╬п╫я▀ п©я─п╬я├п╣я│я│п╟. п▓ я│п╡п╣п╤п╣п╪ п╫п╬п╪п╣я─п╣
> Journal of joint and bone surgery п©п╬я▐п╡п╦п╩п╟я│я▄ п╣я┴п╣ п╬п╢п╫п╟ п╩я▌п╠п╬п©я▀я┌п╫п╟я▐ я─п╟п╠п╬я┌п╟ -
> п╬п╨п╟п╥я▀п╡п╟п╣я┌я│я▐ п©п╬я│п╩п╣ п╨я│п╟п╠п╟п╫п╬п╡ п©п╟я├п╦п╣п╫я┌ я┤п╟я┴п╣ п©п╬п╡я┌п╬я─п╫п╬ п╡п╬п╥п╡я─п╟я┴п╟п╣я┌я│я▐ п╢п╩я▐
> я─п╣п╢я─п╣я│я│п╟я├п╦п╦ п╨п╬п╩п╣п╫п╫п╬пЁп╬ я│я┐я│я┌п╟п╡п╟ п©п╬я│п╩п╣ я█п╫п╢п╬п©я─п╬я┌п╣п╥п╦я─п╬п╡п╟п╫п╦я▐. п║п╪
> я│я│я▀п╩п╨я┐. п≤, п╢п╟, п╡п╟я─я└п╟я─п╦п╫ п©п╬ п©я─п╣п╤п╫п╣п╪я┐ я│п╟п╪я▀п╧ п╫п╟п╥п╫п╟я┤п╟п╣п╪я▀п╧ п©я─п╣п©п╟я─п╟я┌ п╢п╩я▐
> п©я─п╬я└п╦п╩п╟п╨я┌п╦п╨п╦ DVT/PE п©п╬я│п╩п╣ я█п╫п╢п╬п©я─п╬я┌п╣п╥п╦я─п╬п╡п╟п╫п╦я▐ .
>
> https://journals.lww.com/jbjsjournal/Abstract/2018/08150/Type_of_Anticoagulant_Used_After_Total_Knee.2.aspx
>
> п║я│я▀п╩п╨п╦ п©п╬ я─п╬я│я┌я┐ я┤п╟я│я┌п╬я┌я▀ п╦п╫я└п╣п╨я├п╦п╧ п©п╬я│п╩п╣ я█п╫п╢п╬п©я─п╬я┌п╣п╥п╦я─п╬п╡п╟п╫п╦я▐: Wound
> Complications Following Rivaroxaban Administration A Multicenter
> Comparison with Low-Molecular-Weight Heparins for Thromboprophylaxis in
> Lower Limb Arthroplasty
> Simon S. Jameson et al J Bone Joint Surg Am, 2012 Sep 05;94(17):1554-1558.
>
> Wound complications following Rivaroxaban administration - a
> multi-centre comparison with low molecular weight Heparin for
> thromboprophylaxis in lower limb arthroplasty
> M Rymaszewska, S Jameson, P James, I Serrano-Pedraza, S Muller, A Hui
> and M Reed J Bone Joint Surg Br 2012 vol. 94-Bno. SUPP XXXIX 198
>
> Switch to Rivaroxaban Led to Higher Complication Rate
> Terry Stanton, 2012 Annual Meeting News AAOS
>
> A comparison of complications requiring return to theatre in hip and
> knee arthroplasty patients taking enoxaparin versus rivaroxaban for
> thromboprophylaxis. Chahal GS1, Saithna A, Brewster M, Gilbody J, Lever
> S, Khan WS, Foguet P. Ortop Traumatol Rehabil. 2013 Mar-Apr;15(2):125-9.
> doi: 10.5604/15093492.1045953
>
> Elective hip and knee arthroplasty and the effect of rivaroxaban and
> enoxaparin thromboprophylaxis on wound healing. Sindali K1, Rose B,
> Soueid H, Jeer P, Saran D, Shrivastava R. Eur J Orthop Surg Traumatol.
> 2013 May;23(4):481-6. doi: 10.1007/s00590-012-0987-y. Epub 2012 Apr 17.
> Sereda Andrey
>
>
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