medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-20-14-19medsovet-2222Research ArticleКАРДИОЛОГИЯCARDIOLOGYТРОМБОЦИТОПЕНИЯ У БОЛЬНЫХ МНОГОПРОФИЛЬНОГО СТАЦИОНАРА И ВОЗМОЖНЫЕ ПУТИ ОПТИМИЗАЦИИ ЕЕ ОЦЕНКИTHROMBOCYTOPENIA IN THE STRUCTURE OF HEMATOLOGICAL DISORDERS IN PATIENTS OF A MULTIPROFILE HOSPITAL AND POSSIBLE WAYS TO OPTIMIZE ITS EVALUATIONСемиголовскийН. Ю.SemigolovskiiS. Yu.

доктор медицинских наук, профессор.

Санкт-Петербург.

MD, Prof.

Sankt-Petersburg.

 

ВавиловаТ. В.VavilovaT. V.

доктор медицинских наук, профессор.

Санкт-Петербург.

MD, Prof.

Sankt-Petersburg.

КащенкоВ. А.KashchenkoV. A.

доктор медицинских наук.

Санкт-Петербург.

MD.

Sankt-Petersburg.

СемиголовскийС. Н.SemigolovskiiS. N.

Санкт-Петербург.

Sankt-Petersburg.

СапегинА. А.SapeginA. A.

кандидат медицинских наук. 

Санкт-Петербург.

PhD in Medicine.

Sankt-Petersburg.

Клиническая больница №122 им. Л.Г. Соколова Федерального медико-биологического агентства России; Санкт-Петербургский государственный университет.РоссияSokolov’ Hospital №122 of Federal Medical and Biological Agency; Sankt-Petersburg State University.Russian FederationНациональный медицинский исследовательский центр им. В.А. Алмазова Минздрава России.РоссияAlmazov’ National Medical Research Centre.Russian FederationСанкт-Петербургский государственный университет.РоссияSankt-Petersburg State University.Russian FederationКлиническая больница №122 им. Л.Г. Соколова Федерального медико-биологического агентства России.РоссияSokolov’ Hospital №122 of Federal Medical and Biological Agency.Russian Federation2017060120180201419Copyright © Семиголовский Н.Ю., Вавилова Т.В., Кащенко В.А., Семиголовский С.Н., Сапегин А.А., 20182018Семиголовский Н.Ю., Вавилова Т.В., Кащенко В.А., Семиголовский С.Н., Сапегин А.А.Semigolovskii S.Y., Vavilova T.V., Kashchenko V.A., Semigolovskii S.N., Sapegin A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2222

Анализ распространенности тромбоцитопении в многопрофильном стационаре, где пролечивается около 25 000 больных в год, показывает, что от 1,15 до 1,45% пациентов имеют опасное снижение тромбоцитов менее 100 x 109/л. Так, 40,2% из них (в среднем 127 человек в год) получают гепарин и могут потенциально рассматриваться как больные, подозрительные на гепарининдуцированную тромоцитопению (ГИТ). Своевременное выявление таких пациентов, применение двух правил – 4Т и «100–5–100» – позволяет не пропустить больного с развитием ГИТ, вовремя перейти на альтернативные антикоагулянты и при необходимости прекратить промывание венозных катетеров раствором гепарина. Такая тактика позволяет уменьшить количество пациентов, получающих гепарин и имеющих тромбоцитопению ниже 100 х 109/л, почти в 3 раза как в общебольничных, так и в реанимационных отделениях за 3 года использования указанной тактики.

Analysis of the prevalence of thrombocytopenia in a multidisciplinary hospital, where it is treated about 25,000 patients a year, shows that from 1.15% to 1.45% of patients have threat reduction platelets less than 100x109/l. 40,2% of them (on average, 127 people per year) receive heparin and can potentially be seen as patients that are suspected to heparin-induced thrombocytopenia (HIT). Timely identification of such patients, the use of two rules – 4T and «100–5—100» allows you not to miss the patient with the development of HIT, time to switch to alternative anticoagulants and, if necessary, to stop the flushing of venous catheters with heparin solution. This tactic allows to reduce the number of patients, receiving heparin and thrombocytopenia below 100 х 109/l, almost 3 times as took place among hospitalized and patients in intensive care units in 3 years of using the mentioned tactics.

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