clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2021-99-1-6-14clinmed-173Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESСовременные аспекты тромболитической терапии тромбоэмболии легочных артерийPresent aspects of thrombolytic therapy of pulmonary artery thromboembolismhttps://orcid.org/0000-0003-1843-087XОвчинниковЮ. В.OvchinnikovY. V.

Овчинников Юрий Викторович — доктор медицинских наук, доцент, начальник кафедры терапии неотложных состояний

107392, Москва

Yurii V. Ovchinnikov — MD, PhD, DSc, Associate Professor, Head of the Department of Emergency Medicine

107392, Moscow

ovchinnikov.munkc@mail.ruЗеленовМ. В.ZelenovM. V.

107014, Москва

107014, Moscow

ПоловинкаВ. С.PolovinkaV. S.

107392, Москва

107392, Moscow

КрюковЕ. В.KryukovE. V.

194044, Санкт-Петербург

194044, Saint Petersburg

ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» (филиал) Минобороны РоссииРоссияMilitary Medical Academy named after S.M. Kirov (Branch) of the Ministry of Defense of RussiaRussian FederationФКУ «Центральный военный клинический госпиталь имени П.В. Мандрыка» Минобороны РоссииРоссияCentral Military Clinical Hospital named after P.V. Mandryka of the Ministry of Defense of RussiaRussian FederationФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны РоссииРоссияMilitary Medical Academy named after S.M. Kirov of the Ministry of Defense of RussiaRussian Federation202103062021991614Copyright © Овчинников Ю.В., Зеленов М.В., Половинка В.С., Крюков Е.В., 20212021Овчинников Ю.В., Зеленов М.В., Половинка В.С., Крюков Е.В.Ovchinnikov Y.V., Zelenov M.V., Polovinka V.S., Kryukov E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/173

Концепция тромбоэмболии легочных артерий высокого риска определяет, что верификация окклюзии легочного артериального русла требует проведения таким пациентам срочного восстановления проходимости легочного кровотока. Основным методом лечения тромбоэмболии легочных артерий в настоящее время признана тромболитическая терапия, позволяющая спасти жизнь пациентов, предотвратить развитие хронической постэмболической легочной гипертензии и рецидива тромбоэмболии. В литературном обзоре представлены тромболитические препараты, используемые при лечении тромбоэмболии легочных артерий, описаны показания для проведения тромболитической терапии, сравнительная эффективность и безопасность различных тромболитиков. Описаны основные осложнения тромболитической терапии и затронуты вопросы повышения ее безопасности. Критериями успешности тромболизиса являются ранняя диагностика, точная стратификация риска и адекватное использование реперфузионных средств у больных с тромбоэмболией легочных артерий высокого или промежуточного высокого риска.

The concept of high-risk pulmonary artery embolism determines that verification of the occlusion of the pulmonary arterial bed requires urgent restoration of pulmonary blood flow in such patients. Thrombolytic therapy is currently recognized as the main treatment for pulmonary artery thromboembolism. It can save patients’ lives, prevent the development of chronic post embolic pulmonary hypertension and thromboembolism recurrence. The literature review presents thrombolytic medications used in the treatment of pulmonary thromboembolism, describes indications for thrombolytic therapy, comparative efficiency and safety of various thrombolytics. The main complications of thrombolytic therapy are described and the issues of increasing its safety are raised. Criteria for the success of thrombolysis are early diagnosis, accurate risk stratification, and adequate use of reperfusion agents in patients with high-risk or transitionally high-risk of pulmonary embolism.

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