asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»asurgery-19Research ArticleХИРУРГИЯSURGERYНизкомолекулярный гепарин Цибор® - современный опыт применения в хирургической клинической практикеКудыкинМ. Н.noemail@neicon.ruНижГМАRussian Federation20153012201503-43541Copyright © Кудыкин М.Н., 20152015Кудыкин М.Н.Кудыкин М.Н.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/19

Современную клиническую практику нельзя представить без использования антикоагулянтов, и ведущую роль продолжает играть использование гепаринов. Одно из величайших открытий фармакологии - открытие гепарина, наряду с открытием антибиотиков, определило новый вектор в развитии всей клинической медицины и хирургии. Самые разнообразные свойства гепарина как биологического лекарственного средства природного происхождения изучаются на протяжении столетия, начиная с 1916 г., что способствует пополнению базы данных в отношении его эффектов, но на сегодняшний день наиболее частым показанием для назначения гепарина является профилактика и лечение венозного тромбоза и тромбоэмболических осложнений.

венозный тромбозпрофилактикалечениегепаринбемипаринЦибор®ReferencesGuideline on non-ciinicai and clinical development of similar biological medicinal products containing low molecular weight heparins. London, 19 March 2009. EMEA/CHMP/BMWP/118264/2007.Guideline on non-ciinicai and clinical development of similar biological medicinal products containing low molecular weight heparins. London, 19 March 2009. EMEA/CHMP/BMWP/118264/2007.Российские клинические рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений. Ассоциация флебологов России, Всероссийское общество хирургов. М.: Медиа Сфера, 2010.Российские клинические рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений. Ассоциация флебологов России, Всероссийское общество хирургов. М.: Медиа Сфера, 2010.Geerts WH, Bergqvist D, Pineo GF et al. Prevention of Venous Thromboembolism. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008; 133: 381-453.Geerts WH, Bergqvist D, Pineo GF et al. Prevention of Venous Thromboembolism. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008; 133: 381-453.Kearon C, Akl EA, Comerota AJ et al. Antithrombotic therapy for venous thromboembolic disease: antithrombotic therapy and prevention of thrombosis. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (9th Edition). Chest. 2012. 141. 419-494.Kearon C, Akl EA, Comerota AJ et al. Antithrombotic therapy for venous thromboembolic disease: antithrombotic therapy and prevention of thrombosis. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (9th Edition). Chest. 2012. 141. 419-494.Guidelines o the diagnosis and management of acute pulmonary embolism. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology. Eur Heart J. 2008; 29: 2276-2315.Guidelines o the diagnosis and management of acute pulmonary embolism. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology. Eur Heart J. 2008; 29: 2276-2315.Falkon L, Saenz-Campos D, Antonijoan R, Martin S, Barbanoj M, Fontcuberta J. Bioavailability and pharmacokinetics of a new low molecular weight heparin (RO-11). A three way cross-over study in healthy volunteers. Thromb. Res. 1995; 78: 77-86.Falkon L, Saenz-Campos D, Antonijoan R, Martin S, Barbanoj M, Fontcuberta J. Bioavailability and pharmacokinetics of a new low molecular weight heparin (RO-11). A three way cross-over study in healthy volunteers. Thromb. Res. 1995; 78: 77-86.Borrell M, Antonijoan RM, Ortin R et al. Pharmacokinetic profiles of two LMWH: Bemiparin 3,500 IU and Enoxaparin 4,000 IU after subcutaneous administration in healthy volunteers. Thromb. Haemost. 2001; 86: Suppl.: CD3578.Borrell M, Antonijoan RM, Ortin R et al. Pharmacokinetic profiles of two LMWH: Bemiparin 3,500 IU and Enoxaparin 4,000 IU after subcutaneous administration in healthy volunteers. Thromb. Haemost. 2001; 86: Suppl.: CD3578.Falkon L, Bayes M, Frontera G, Gari M, Barbanoj M, Fontcu-berta J. Pharmacokinetics and tolerability of a new low molecular mass heparin (RO-11) in healthy volunteers - a dose-finding study within the therapeutical range. Thromb. Haemost. 1997; 77: 133-136.Falkon L, Bayes M, Frontera G, Gari M, Barbanoj M, Fontcu-berta J. Pharmacokinetics and tolerability of a new low molecular mass heparin (RO-11) in healthy volunteers - a dose-finding study within the therapeutical range. Thromb. Haemost. 1997; 77: 133-136.Collignon F, Frydman A, Caplain H et al.: Comparison of the pharmacokinetic profiles of three low molecular mass heparins - dalte- parin, enoxaparin, nadroparin - administered subcutaneousiy in heathy volunteers (doses for prevention of thromboembolism). Thromb. Haemost. 1995; 73: 630-640.Collignon F, Frydman A, Caplain H et al.: Comparison of the pharmacokinetic profiles of three low molecular mass heparins - dalte- parin, enoxaparin, nadroparin - administered subcutaneousiy in heathy volunteers (doses for prevention of thromboembolism). Thromb. Haemost. 1995; 73: 630-640.Eriksson BI, Soderberg K, Widiund L, Wandeii B, Tengborn L. A comparative study of three iow-moiecuiar weight heparins (LMWH) and unfractionated heparin (UH) in healthy voiunteers. Thromb. Haemost. 1995; 73: 398-401.Eriksson BI, Soderberg K, Widiund L, Wandeii B, Tengborn L. A comparative study of three iow-moiecuiar weight heparins (LMWH) and unfractionated heparin (UH) in healthy voiunteers. Thromb. Haemost. 1995; 73: 398-401.Moreno Gonzaiez E, Fontcuberta J, De La Liama F. Prophyiaxis of thromboemboiic disease with RO-11 (ROVI), during abdominai surgery. Hepatogastroenterology. 1996; 43: 744-747.Moreno Gonzaiez E, Fontcuberta J, De La Liama F. Prophyiaxis of thromboemboiic disease with RO-11 (ROVI), during abdominai surgery. Hepatogastroenterology. 1996; 43: 744-747.Kakkar W, Howes J, Sharma V, Kadzioia Z. A comparative, doubie-biind, randomized triai of a new-second generation LMWH (Bemiparin) and UFH in the prevention of post-operative venous thromboemboiism in patients undergoing hip arthropiasty. Thromb. Haemost. 2000; 83: 523-529.Kakkar W, Howes J, Sharma V, Kadzioia Z. A comparative, doubie-biind, randomized triai of a new-second generation LMWH (Bemiparin) and UFH in the prevention of post-operative venous thromboemboiism in patients undergoing hip arthropiasty. Thromb. Haemost. 2000; 83: 523-529.Abad JI, Gomez-Outes A, Martinez-Gonzaiez J, Rocha E. A prospective observationai study on the effectiveness and safety of be-miparin, first dose administered 6 h after knee or hip repiacement surgery. Arch Orthop Trauma Surg. 2007 Oct; 127 (8): 665-670.Abad JI, Gomez-Outes A, Martinez-Gonzaiez J, Rocha E. A prospective observationai study on the effectiveness and safety of be-miparin, first dose administered 6 h after knee or hip repiacement surgery. Arch Orthop Trauma Surg. 2007 Oct; 127 (8): 665-670.Navarro-Quiiis A, Casteiiet E, Rocha E, Paz-Jimenez J, Pianes A. Efficacy and safety of bemiparin compared with Enoxaparin in the prevention of venous thromboemboiism after totai knee arthropiasty. A randomized doubie-biind ciinicai triai. J. Thromb. Haemost. 2003; 1: 425-432.Navarro-Quiiis A, Casteiiet E, Rocha E, Paz-Jimenez J, Pianes A. Efficacy and safety of bemiparin compared with Enoxaparin in the prevention of venous thromboemboiism after totai knee arthropiasty. A randomized doubie-biind ciinicai triai. J. Thromb. Haemost. 2003; 1: 425-432.Vavken P, Lunzer A., Grohs JG. A prospective cohort study on the effectiveness of 3500 IU versus 5000 IU bemiparin in the prophyiaxis of postoperative thrombotic events in obese patients undergoing orthopedic surgery. Wien Klin Wochenschr. 2009; 121 (13-14): 454-458.Vavken P, Lunzer A., Grohs JG. A prospective cohort study on the effectiveness of 3500 IU versus 5000 IU bemiparin in the prophyiaxis of postoperative thrombotic events in obese patients undergoing orthopedic surgery. Wien Klin Wochenschr. 2009; 121 (13-14): 454-458.Rodriguez-Manas L, Gomez-Hueigas R, Veiga-Fernandez F, Ruiz GM, Gonzaiez JM Thromboprophyiaxis with the iow-moiecuiar-weight heparin bemiparin sodium in eid-eriy medicai patients in usuai ciinicai practice: the ANCIANOS study. Clin Drug Investig. 2010; 30 (5): 337-345.Rodriguez-Manas L, Gomez-Hueigas R, Veiga-Fernandez F, Ruiz GM, Gonzaiez JM Thromboprophyiaxis with the iow-moiecuiar-weight heparin bemiparin sodium in eid-eriy medicai patients in usuai ciinicai practice: the ANCIANOS study. Clin Drug Investig. 2010; 30 (5): 337-345.Baiibrea JL, Aitimiras J, Larruzea I, Gomez-Outes A, Martinez-Gonzaiez J, Rocha E. Optimai dosing of bemiparin as prophyiaxis against venous thromboemboiism in surgery for cancer: an audit of practice. Int J Surg. 2007 Apr; 5 (2): 114-119.Baiibrea JL, Aitimiras J, Larruzea I, Gomez-Outes A, Martinez-Gonzaiez J, Rocha E. Optimai dosing of bemiparin as prophyiaxis against venous thromboemboiism in surgery for cancer: an audit of practice. Int J Surg. 2007 Apr; 5 (2): 114-119.Kakkar W, Baiibrea JL, Martinez-Gonzaiez J, Prandoni P. Extended prophyiaxis with bemiparin for the prevention of venous thromboemboiism after abdominai or peivic surgery for cancer: the CANBE-SURE randomized study. J Thromb Haemost. 2010 Jun; 8 (6): 1223-1229.Kakkar W, Baiibrea JL, Martinez-Gonzaiez J, Prandoni P. Extended prophyiaxis with bemiparin for the prevention of venous thromboemboiism after abdominai or peivic surgery for cancer: the CANBE-SURE randomized study. J Thromb Haemost. 2010 Jun; 8 (6): 1223-1229.Kakkar W, Gebska M, Kadzioia Z, Saba N, Carrasco P. Lowmoiecuiar weight heparin in the acute and iong-term treatment of deep- vein-thrombosis. Thromb. Haemost. 2003; 89: 674-680.Kakkar W, Gebska M, Kadzioia Z, Saba N, Carrasco P. Lowmoiecuiar weight heparin in the acute and iong-term treatment of deep- vein-thrombosis. Thromb. Haemost. 2003; 89: 674-680.Santamaria A, Juarez S, Reche A, Gomez-Outes A, Martinez-Gonzaiez J, Fontcuberta J. Low-moiecuiar-weight heparin, bemiparin, in the outpatient treatment and secondary prophyiaxis of venous thromboemboiism in standard ciinicai practice: the ESFERA study. Int J Clin Pract. 2006; 60 (5): 518-525.Santamaria A, Juarez S, Reche A, Gomez-Outes A, Martinez-Gonzaiez J, Fontcuberta J. Low-moiecuiar-weight heparin, bemiparin, in the outpatient treatment and secondary prophyiaxis of venous thromboemboiism in standard ciinicai practice: the ESFERA study. Int J Clin Pract. 2006; 60 (5): 518-525.Lecumberri R, Rosario E, Pacho J, Rocha E. Fixed-dose iow- moiecuiar-weight heparin, bemiparin, in the iong-term treatment of venous thromboemboiism in patients with transient risk factors in standard ciinicai practice: the FLEBUS study. J Thromb Haemost. 2006; 4: 2504-2508.Lecumberri R, Rosario E, Pacho J, Rocha E. Fixed-dose iow- moiecuiar-weight heparin, bemiparin, in the iong-term treatment of venous thromboemboiism in patients with transient risk factors in standard ciinicai practice: the FLEBUS study. J Thromb Haemost. 2006; 4: 2504-2508.Constans M, Santamaria A, Mateo J, Pujoi N, Souto JC, Font-cuberta J. Low-moiecuiar-weight heparin as bridging therapy during interruption of orai anticoaguiation in patients undergoing coionoscopy or gastroscopy. Int J Clin Pract. 2007; 61: 212-217.Constans M, Santamaria A, Mateo J, Pujoi N, Souto JC, Font-cuberta J. Low-moiecuiar-weight heparin as bridging therapy during interruption of orai anticoaguiation in patients undergoing coionoscopy or gastroscopy. Int J Clin Pract. 2007; 61: 212-217.Aiaiaf SK, Jawad RK, Muhammad PR, Aii MS, Ai Tawii NG. Bemiparin versus enoxaparin as thromboprophyiaxis foiiowing vaginai and abdominai deiiveries: a prospective ciinicai triai. BMCPregnancy Childbirth. 2015 Mar 28; 15: 72.Aiaiaf SK, Jawad RK, Muhammad PR, Aii MS, Ai Tawii NG. Bemiparin versus enoxaparin as thromboprophyiaxis foiiowing vaginai and abdominai deiiveries: a prospective ciinicai triai. BMCPregnancy Childbirth. 2015 Mar 28; 15: 72.Ciccone MM, Cortese F, Corbo F, Corraies NE, Ai-Momen AK, Siiva A, Zito A, Pinto M, Gesuaido M, Scicchitano P. Bemiparin, an effective and safe iow moiecuiar weight heparin: a review. Vascul Pharmacol. 2014 Jui; 62(1): 32-7.Ciccone MM, Cortese F, Corbo F, Corraies NE, Ai-Momen AK, Siiva A, Zito A, Pinto M, Gesuaido M, Scicchitano P. Bemiparin, an effective and safe iow moiecuiar weight heparin: a review. Vascul Pharmacol. 2014 Jui; 62(1): 32-7.

The authors declare that there are no conflicts of interest present.