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Профилактика и лечение кровотечений, ассоциированных с приемом прямых оральных антикоагулянтов

https://doi.org/10.30629/0023-2149-2020-98-7-491-497

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Аннотация

Прямые оральные антикоагулянты (ПОАК), которые включают в себя ингибитор тромбина (дабигатран) и ингибиторы активированного фактора Х свертывания крови (ривароксабан, апиксабан, эдоксабан, бетриксабан), получили широкое распространение во всем мире для профилактики и лечения венозных тромбозов. Популярность ПОАК объясняется удобной и предсказуемой фармакодинамикой, отсутствием необходимости в регулярном мониторинге терапевтического эффекта, а также менее выраженным влиянием пищи и препаратов на их биодоступность. Однако, как и для любых других антикоагулянтов, для ПОАК характерен повышенный риск кровотечений, в особенности желудочно-кишечных. Корректный подход к назначению ПОАК и профилактике кровотечений на фоне лечения антикоагулянтами способен существенно снизить вероятность развития жизнеугрожающих осложнений. В случае развития кровотечения показано применение специфических и неспецифических антидотов ПОАК. Значимое кровотечение требует знания лечащим врачом четкого порядка действий в соответствии с опубликованными алгоритмами для спасения жизни пациента.

Об авторах

Я. А. Носков
ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Минобороны России
Россия

Носков Ярослав Алексеевич — кандидат медицинских наук, старший ординатор гематологического отделения клиники кафедры факультетской терапии

194044, Санкт-Петербург



А. С. Поляков
ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Минобороны России
Россия
194044, Санкт-Петербург


Е. С. Братилова
ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Минобороны России
Россия
194044, Санкт-Петербург


В. В. Тыренко
ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Минобороны России
Россия
194044, Санкт-Петербург


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Для цитирования:


Носков Я.А., Поляков А.С., Братилова Е.С., Тыренко В.В. Профилактика и лечение кровотечений, ассоциированных с приемом прямых оральных антикоагулянтов. Клиническая медицина. 2020;96(7):491-497. https://doi.org/10.30629/0023-2149-2020-98-7-491-497

For citation:


Noskov Ya.A., Polyakov A.S., Bratilova E.S., Tyrenko V.V. The prevention and treatment of bleeding associated with direct oral anticoagulants. Clinical Medicine (Russian Journal). 2020;96(7):491-497. (In Russ.) https://doi.org/10.30629/0023-2149-2020-98-7-491-497

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ISSN 0023-2149 (Print)
ISSN 2412-1339 (Online)