asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/akh2025-039asurgery-589Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCE | PRACTICEМестная терапия в лечении острого тромбоза поверхностных венLocal therapy in the treatment of acute superficial vein thrombosishttps://orcid.org/0000-0003-3811-5156ДженинаО. В.DzheninaO. V.

Дженина Ольга Вадимовна, к.м.н., врач-флеболог, ведущий специалист,

117447, Москва, ул. Дмитрия Ульянова, д. 31

Olga V. Dzhenina, Cand. Sci. (Med.), Phlebologist, Leading Specialist,

31, Dmitry Ulyanov St., Moscow, 117447

helgelman@mail.ruhttps://orcid.org/0000-0002-3940-0787БогачевВ. Ю.BogachevV. Yu.

Богачев Вадим Юрьевич, д.м.н., профессор, профессор кафедры хирургии факультета усовершенствования врачей, руководитель курса амбулаторной и эстетической флебологии, 129110, Москва, ул. Щепкина, д. 61/2, корп. 1;

научный руководитель, 117447, Москва, ул. Дмитрия Ульянова, д. 31

Vadim Yu. Bogachev, Dr. Sci. (Med.), Professor, Professor of the Department of Surgery, Faculty of Advanced Medical Studies, Head of the Outpatient and Aesthetic Phlebology Course, 61/2, Bldg. 1, Schepkin St., Moscow, 129110;

Scientific Supervisor, 31, Dmitry Ulyanov St., Moscow, 117447

vadim.bogachev63@gmail.comПервый флебологический центрРоссияFirst Phlebological CenterRussian FederationМосковский областной научно-исследовательский клинический институт имени М.Ф. Владимирского; Первый флебологический центрРоссияMoscow Regional Research Clinical Institute named after M.F. Vladimirsky; First Phlebological CenterRussian Federation202525112025222149155Copyright © Дженина О.В., Богачев В.Ю., 20252025Дженина О.В., Богачев В.Ю.Dzhenina O.V., Bogachev V.Y.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/589

Согласно международным и российским рекомендациям, лечение тромбоза поверхностных вен должно быть комплексным и включать в себя системную фармакотерапию (в том числе антикоагулянтную), эластическую компрессию и топические средства. При этом местные препараты могут быть использованы самостоятельно в случае малой протяженности тромбированного участка и низкого риска перехода тромба на глубокое венозное русло. В настоящее время доказано, что эффективность действия топических средств зависит в том числе от лекарственной формы, и гели отличаются более эффективной трансдермальной доставкой по сравнению с мазями. Также на эффективность действующего вещества влияет не только исходная концентрация в препарате, но и степень сохранения концентрации после проникновения в дерму и гиподерму. Современная местная терапия тромбоза поверхностных вен включает в себя гели на основе гепарина и нестероидных противовоспалительных средств, а также локальное охлаждение. Местная фармакотерапия оказывает противовоспалительное и анальгезирующее действие, а гипотермия усиливает анальгезию. Уменьшение выраженности воспалительного процесса улучшает качество жизни пациента и повышает его приверженность к другим направлениям комплексного лечения.

According to international and Russian guidelines, superficial vein thrombosis treatment should be comprehensive and include systemic drug therapy (i.e. anticoagulant therapy), elastic compression and topical preparations. At the same time, local preparations can be self-administered, if the length of blocked portion of the vein is short and a risk of clot breaking off and travelling to the deep veins is low. The effectiveness of topical preparations has been proven to depend, among other things, on the dosage forms, and gels are characterized by more effective transdermal delivery as compared to ointments. Also, the efficacy of the active substance is affected not only by its initial concentration in the drug, but also by the extent to which the concentration is maintained after penetration into the dermis and hypodermis. The current local therapy for superficial vein thrombosis includes heparin gels and nonsteroidal anti-inflammatory drugs, as well as local cooling. The local drug therapy has an anti-inflammatory and analgesic action, and hypothermia enhances analgetic effects. Reduction in the severity of inflammatory process improves the patients' quality of life and increases their commitment to other complex treatments.

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