asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»asurgery-88Research ArticleФЛЕБОЛОГИЯ | АНГИОЛОГИЯPHLEBOLOGY | ANGIOLOGYВторичная профилактика венозных тромбоэмболических осложнений. В фокусе - дабигатранSecondary prevention of venous thromboembolic complications. Focus on dabigatraneБогачевВ. Ю.BogachevV.Y.noemail@neicon.ruБолдинБ. В.BoldinB. V.noemail@neicon.ruДженинаО. В.DjeninaО.V.noemail@neicon.ruЛобановВ. Н.LobanovV. N.noemail@neicon.ruГБОУ ВПО РНИМУ им. Н.И. ПироговаРоссияPirogov Russian Medical UniversityRussian FederationПервый флебологический центрРоссияFirst Phlebologic CenterRussian Federation20173012201703-43642Copyright © Богачев В.Ю., Болдин Б.В., Дженина О.В., Лобанов В.Н., 20172017Богачев В.Ю., Болдин Б.В., Дженина О.В., Лобанов В.Н.Bogachev V., Boldin B.V., Djenina О., Lobanov V.N.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/88

Венозные тромбоэмболические осложнения (ВТЭО) - часто встречающаяся патология, сопровождающаяся высокой летальностью. После перенесенных ВТЭО сохраняется риск их рецидива, но не эквивалентный для всех пациентов. Доступная в настоящее время антикоагулянтная терапия эффективно препятствует рецидиву ВТЭО, повышая при этом вероятность кровотечений. То есть при планировании вторичной профилактики необходимо соблюсти оптимальный баланс между вероятностью рецидива ВТЭО и развитием геморрагических осложнений. Таким образом, отбор пациентов для вторичной профилактики должен сопровождаться всесторонним анализом многочисленных факторов, определяющих как вероятность рецидива ВТЭО, так и риск развития осложнений. Варфарин - наиболее часто используемый для длительной антикоагулянтной per os терапии препарат, требует частого мониторинга с периодической коррекцией дозы и строгих диетических ограничений. Новые оральные антикоагулянты (НОАК) применяют в фиксированной дозе без обязательного строгого гемостазиологического контроля, что делает их весьма привлекательными для продолженной вторичной профилактики ВТЭО.

Venous thromboembolic complications (VTEC) are a frequent pathology accompanied by high lethality. After VTEC the risk of their recurrence not equivalent for all patients remains. The anticoagulant therapy available currently effectively prevents VTEC increasing a possibility of hemorrhages. This means that at planning the secondary prevention it’s necessary to maintain the optimal balance between a possibility of recurrence of VTEC and development of hemorrhagic complications. Thus, selection of patients for secondary prevention must be accompanied by a comprehensive analysis of numerous factors as determining the possibility of VTEC recurrence as well as a risk of complications development. Warfarin is the most frequently used drug for long-term anticoagulant per os therapy, it requires frequent monitoring with periodic dose correction and strict dietary limitations. New oral anticoagulants (NOAC) are applied at a fixed dose without obligatory strict hemostasiologic control, which makes them rather attractive for continues secondary prevention of VTEC.

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