The problem of hemorrhagic syndrome in its treatment with vitamin K antagonists (a review of literature)


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Abstract

Vitamin K antagonists (warfarin, syncumar, phenylin, etc.) are commonly used to treat and prevent thrombotic diseases. The risk for varying degrees of hemorrhagic syndrome (intracranial hemorrhage in particular) is the most important problem in the use of drugs from this group. The rapid neutralization of the effects of used anticoagulants, which is verified by correcting the international normalized ratio (INR), is required in these cases and when emergency surgical interventions are needed. Transfusions of prothrombin complex concentrates (PCCs) in combination of vitamin K preparations are optimal for this purpose. The reason for the rational use of PCCs to promptly correct INR is the balanced composition of this transfusion medium (a combination of blood coagulation factors and biological anticoagulants). This regimen for emergency correction of INR minimizes the risk of thrombotic events.

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Проблема геморрагического синдрома при лечении антагонистами витамина К. - Аннотация. Для лечения и профилактики тромботических заболеваний часто используются препараты - антагонисты витамина К (варфарин, синкумар, фенилин и др.). Важнейшей проблемой при использовании препаратов этой группы является риск развития различной степени тяжести геморрагического синдрома (особенно внутричерепных кровотечений). В подобных случаях, а также при необходимости срочных хирургических вмешательств требуется быстрая нейтрализация действия применяемых антикоагулянтов, выверяемая по коррекции международного нормализованного отношения (МНО). Оптимальным для этой цели представляется применение трансфузий концентратов протромбинового комплекса (КПК) в сочетании с введением препаратов витамина К. Причиной рациональности применения КПК для срочной коррекции МНО является сбалансированность состава этой трансфузионной среды (сочетание факторов свертывания крови с биологическими антикоагулянтами). Такая схема экстренной коррекции МНО сводит к минимуму риск развития тромботических осложнений.
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