ПЛАНОВЫЕ НЕКАРДИАЛЬНЫЕ ХИРУРГИЧЕСКИЕ ВМЕШАТЕЛЬСТВА И АНТИТРОМБОТИЧЕСКАЯ ТЕРАПИЯ
Обзорная статья
Дата публикации: января 13, 2021
Ключевые слова
ннекардиальная хирургия
антикоагулянты
дезагреганты
кровотечение
тромбоз
антикоагулянты
дезагреганты
кровотечение
тромбоз
Аннотация
В последние годы увеличилось количество пациентов, длительно получающих антитромботические препараты для предотвращения ишемических и тромбоэмболических сердечно-сосудистых событий. Выполнение плановых оперативных вмешательств у таких больных сопряжено с риском возникновения как геморрагических, так и тромбоэмболических осложнений. Клиницисту необходимо учитывать множество факторов, влияющих на систему гемостаза: базовую терапию, назначенную пациенту, оперативное вмешательство, препараты для анестезии, иммобилизацию больного и др. В настоящей статье с позиций мультидисциплинарного подхода рассматриваются вопросы курации коморбидных больных, которым выполнены плановые хирургические операции.Литература
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20. Smilowitz N. R., Lorin J., Berger J. S. Risks of noncardiac surgery early after percutaneous coronary intervention //American Heart Journal. – 2019. – V. 217. – P. 64-71. doi: 10.1016/j.ahj.2019.07.010.
21. Egholm G. et al. Risk associated with surgery within 12 months after coronary drug-eluting stent implantation //Journal of the American College of Cardiology. – 2016. – V. 68. – №. 24. – P. 2622-2632.doi: 10.1016/j.jacc.2016.09.967.
22. Helwani M. A. et al. Etiology of acute coronary syndrome after noncardiac surgery //Anesthesiology: The Journal of the American Society of Anesthesiologists. – 2018. – V. 128. – №. 6. – P. 1084-1091. doi: 10.1097/ALN.0000000000002107.
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24. Mahmoud K. D. et al. Perioperative cardiovascular risk of prior coronary stent implantation among patients undergoing noncardiac surgery //Journal of the American College of Cardiology. – 2016. – V. 67. – №. 9. – P. 1038-1049. doi: 10.1016/j.jacc.2015.11.063.
25. Anwaruddin S. et al. Characterization of post-operative risk associated with prior drug-eluting stent use //JACC: Cardiovascular Interventions. – 2009. – V. 2. – №. 6. – P. 542-549. doi: 10.1016/j.jcin.2009.03.014.
26. Schouten O. et al. Noncardiac surgery after coronary stenting: early surgery and interruption of antiplatelet therapy are associated with an increase in major adverse cardiac events //Journal of the American College of Cardiology. – 2007. – V. 49. – №. 1. – P. 122-124. DOI:10.1016/j.jacc.2006.10.004.
27. Devereaux P. J. et al. Aspirin in patients undergoing noncardiac surgery //N Engl J Med. – 2014. – V. 370. – С. 1494-1503. DOI: 10.1056 / NEJMoa1401105
28. Park S. K. et al. Risk of non-cardiac surgery after percutaneous coronary intervention with drug-eluting stents //Scientific reports. – 2017. – V. 7. – №. 1. – P. 1-9. doi: 10.1038/s41598-017-16672-z.
29. Graham M. M. et al. Aspirin in patients with previous percutaneous coronary intervention undergoing noncardiac surgery //Annals of internal medicine. – 2018. – V. 168. – №. 4. – P. 237-244. doi: 10.7326/M17-2341.
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