V.F.Snegirev Archives of Obstetrics and GynecologyV.F.Snegirev Archives of Obstetrics and GynecologyАрхив акушерства и гинекологии им. В.Ф. Снегирева2313-87262687-1386Eco-Vector5696610.17816/2313-8726-2020-7-4-216-224Clinical case reportsКлинические случаиClinical case reportsResearch ArticleThe first experience of using alteplase in the treatment of venous thromboembolic complications in women while taking oral contraceptivesПервый опыт применения альтеплазы при лечении венозных тромбоэмболических осложнений, развившихся у женщин на фоне приёма оральных контрацептивовShpilyanskiyE. M.ШпилянскийЭ. М.
Russian Federation
shp1961@inbox.ruhttps://orcid.org/0000-0003-0663-2909MurashkoA. V.МурашкоА. В.
Russian Federation
murashkoa@mail.ruhttps://orcid.org/0000-0002-0073-160XSukharevaT. V.СухареваТ. В.
Russian Federation
suharewa.tatiana@yandex.ruhttps://orcid.org/0000-0002-4167-5261MorozovK. M.МорозовК. М.
Russian Federation
morozovkonstantin@yandex.ruLarinaD. V.ЛаринаД. В.
Russian Federation
idilya@inbox.ruVeselkovaYu. A.ВеселковаЮ. А.
Russian Federation
morozovkonstantin@yandex.ruhttps://orcid.org/0000-0002-6767-3002KolesnikD. I.КолесникД. И.
Russian Federation
xrey@yandex.ruKir’yanovaE. N.КирьяноваЕ. Н.
Russian Federation
kirieshkak@list.ruГБУЗ МО «Королёвская городская больница»ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава РоссииООО «Гута Клиник»ГБУЗ «Городская клиническая больница им. В.В. Вересаева Департамента здравоохранения г. Москвы»ГКУ «Центральный клинический госпиталь Федеральной таможенной службы России»27122020742162242612202026122020Copyright ©; 2020, Eco-VectorCopyright ©; 2020, ООО "Эко-Вектор"2020Eco-VectorООО "Эко-Вектор"https://archivog.com/2313-8726/article/view/56966

Introduction. Pulmonary embolism (PE) is potentially life-threatening complication that could develop in hormonal contraceptive users. Therapeutic thrombolysis is safe, relatively modern and effective method of treatment.

Aim of the study — to summarize our own experience of thrombolytic therapy of PE in women OC users.

We presented three cases of PE developed in association with oral contraceptive use. Tree female patients aged 20 years, 34 years, 47 years at admittance to hospital were diagnosed PE.

Result. All patients got thrombolytic therapy with alteplase 100 mg iv (10 mg bolus iv, then 90 mg continuous iv injection by infusomat). Good clinical outcomes were reached in all cases.

Conclusion. Our experience shows that alteplase is highly effective agent in PE treatment in women with TE after hormonal contraception.

Keywords: hormonal contraception; venous thrombosis; pulmonary embolism; thrombolysis.

Введение. Одна из актуальных проблем современной гемостазиологии — развитие тромбообразования в венах с последующим возникновением тромбоэмболии, в том числе вследствие приёма гормональных контрацептивных средств. В настоящее время огромное внимание уделяется методам лечения тромбоэмболии как средству первой помощи, направленной на спасение жизни больного. Все больший интерес вызывают методы терапевтического тромболизиса.

Цель исследования — обобщить собственный опыт применения тромболитической терапии у женщин с тромбоэмболией, развившейся на фоне приёма гормональных контрацептивных препаратов.

В статье представлены 3 клинических случая лечения больных женского пола в возрасте 20, 34 и 47 лет. У всех трёх женщин развилась тромбоэмболия лёгочной артерии (ТЭЛА) на фоне приёма оральных контрацептивов.

Результаты. Всем пациенткам проведена тромболитическая терапия препаратом альтеплаза, 100 мг по схеме 10 мг внутривенно (в/в) струйно, 90 мг в/в через инфузомат. У всех пациенток получен хороший клинический результат.

Заключение. Наш опыт свидетельствует о высокой эффективности альтеплазы при тромбозе глубоких вен и ТЭЛА у женщин после спонтанных венозных тромбозов на фоне приёма гормональных контрацептивов.

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