Гастроинтестинальные кровотечения на фоне приема антикоагулянтов: риск возникновения, профилактика и лечение


DOI: https://dx.doi.org/10.18565/therapy.2020.7.43-53

Е.Ю. Плотникова, Л.К. Исаков, М.Н. Синькова, Е.Н. Гуляева

ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава России
Антикоагулянты, включая дикумарины и пероральные антикоагулянты прямого действия, широко используются для профилактики или лечения венозной тромбоэмболии и предотвращения артериальной тромбоэмболии. Однако применение этих препаратов таит повышенный риск гастроинтестинальных кровотечений, сопряженных с опасными осложнениями и смертностью в пределах от 1 до 13%, по данным разных авторов. В статье приводятся варианты гастроинтестинальных событий на фоне антикоагулянтной терапии, оцениваются группы риска этих событий. Описаны варианты гастроэнтеропротекции у пациентов разных возрастных групп с учетом состояния их гастроинтестинальной слизистой оболочки. Рассматриваются данные по применению в качестве гастроэнтеропротекторов ингибиторов протонной помпы, Н2-блокатора и препарата ребамипид.
Ключевые слова: антикоагулянты, антиагреганты, новые оральные антикоагулянты, риск кровотечения, ингибиторы протонной помпы, Н2-блокаторы, ребамипид
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Об авторах / Для корреспонденции

Екатерина Юрьевна Плотникова, д.м.н., профессор кафедры поликлинической терапии, последипломной подготовки и сестринского дела, руководитель курса клинической гастроэнтерологии ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава России. Адрес: 650022, г. Кемерово, ул. Ворошилова, д. 22а. Тел.: 8 (913) 434-86-46. E-mail: eka-pl@rambler.ru. ORCID: 0000-0002-6150-1808
Леонид Константинович Исаков, к.м.н., доцент кафедры поликлинической терапии, последипломной подготовки и сестринского дела ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава России. Адрес: 650000, г. Кемерово, ул. 50 лет Октября, д. 10. E-mail: cafpoliclinica@mail.ru. ORCID: 0000-0003-0487-3880
Маргарита Николаевна Синькова, к.м.н., доцент кафедры поликлинической терапии, последипломной подготовки и сестринского дела ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава России. Адрес: 650000, г. Кемерово, ул. 50 лет Октября, д. 10. E-mail: cafpoliclinica@mail.ru. ORCID: 0000-0001-7604-5481
Елизавета Николаевна Гуляева, д.м.н., профессор кафедры профессор кафедры поликлинической терапии, последипломной подготовки и сестринского дела ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава России. Адрес: 650000, г. Кемерово, ул. 50 лет Октября, д. 10. E-mail: cafpoliclinica@mail.ru

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