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ivnpocpeocop Ka^BOJlbHROA
OTHCT o paiij|oivni3npoBaiiiiOM cpaBiiHTCJibiioivinpHMeiieiiini rpancKcaMOBOH KHCJIOTI>I («TpaneKcaM») H
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6biTb paBHOMepno OKpamena B po3OBO-KpacnbiH HBCT, 6biTb KPOBHHHCTO-neHHCTOH, p^caBoro HJIH ^ejiTo-KopHHiieuoro usera. B SojibiuHHCTBeKpoBoxapKaHte BbisbiBaexcfl zuiane/jesHbiM BLIXO^OM apuxpouHTOB usKpOBCHOCHoro pycua npH BOSpacTaiiHH ^aBJieHMa B cocyzie, na (Jjone
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B cponnoH rocnHTajin3au0H H oKa3aHHH
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HJIH 6ojibiiiOM Kpyre KpOBOo6pameiiH>i, yMCHbiiiHTb npOHHqaeMocTb KanHjuiapoBnerKoro H noBbiCHTb cBepTbisaeMOCTb KPOBH, Boec'raeoBHTb npoxonnMocTbBO34yxoBoziHbix nyxeM H npe^ynpe;j[HTb reMoanHpauHOHHyio nHCBMOHHio,BOCnOJIHHTb KpOBOHOTepIO.
KpOBoxapKaHbe H jicroniiwc KpoBOTenciinfl - nanGojiee nacxbieocjio^HeHHa, cymecTBCHHo OTaroruaioiuHe cocToaiiHe GonbHbix Ty6epKyjie3OM, ay 5-15% HEJiHtoinnecfl npHHHiiaMM jreTanbiioro ncxo/ia. KpOBoxapKaHbe nameBcero BCTpenaerca y 6ojibHbix apejioro B03pacrra. Han6ojiee pacnpocxpaHeHHbiMHHpHHHHaMH H JierOHHblX KpOBOTCHCHHH HBJ151IOTCfl 6pOHXO3KTa3HH, 6pOHXHT,
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Ty6epKyne3 - o^na H3 jipcBiieHiiiMxTaK,Ty6epKyjie3Hoe nopa}KeHHe no3BOiiKOB 6buio HanneHO yB rpeqHH Ty6epKyjie3 Hasbinajin phtisis HJIH «HCTomeHHe», «naxoTKa». OT3ioro cjiosa npOHCxoAHT H coBpcMciiiioc nasBaHHe HayKH, H3ynaioineHxy6epKyjie3 - 4)TH3HaxpHJi; a cnenHajiHCTw, H3yHaiom,He ry6epKyjie3,(J)TH3HaTpaMH. B XVII - XVIII BCKax, B nepHo/i yp6aHH3auHH H pe3Koro pa3BHTHanpOMbiiiuieHHOCTH, 3a6ojieBacMoc'ib Ty6epKyjie30M npno6pejia B EsponexapaKiep 3nHjieMHH. B 1 650 ro/*y 20% cMepTefi cpezin >KHTejiew AHFJIHH HVsjibca 6biJio o6ycjTOBJieno Ty6epKyjie3OM. B nepBOH nojroBHHe XX3a6ojieBaeMOCTb Ty6epKy;ie3OM B pa3BHTbix cipanax crajia cHM>KaTbHa OTCyTCTBHC 3(})4)eKTHBHbIX MCTO/lOB JICHCIIHa, HTO 6bIJlO o6yCJTOBJlCHO
yjiyHlHeHHCM COUHaJlbHO-3KOHOMHHCCKHX yCJIOBHH >KH3HH, 3 TaK^CC H3OJlflHHeii
6ojibHbix. OflnaKO K 80-M ro^aM XX Bexa B pa3BHTbix cxpaHax 6biJi BHOBbsaperncTpHpoBan no^teM 3a6ojieeaeMOCTH ry6epKyjie3OM.
B POCCHH ncurbeM 3a6ojiciiacMocTH Ty6cpKy;ie3OM Hanajica B 1991H ^ocxiir MaKCHMajibHoro siianciiMa - 83 ^ejioucKa Ha 100 Tbic HacejieHna - B
BpCMSI POCCHH OXHOCHXCfl K 22-M C'lpEHaM C C3MOH BblCOKOH 3a6oJieBaeMOCXbK)
xy6epKyjie3OM. PHCK saGojiexb cymecxBemio lasucHT ox B03pacxao. Cpc/in HH<j)HUHpOBaHHbix 3a6ojieBaeMOCXb xy6epKyjie3OM
BbicoKa B JOHOUICCKOM H MOJIO/IOM B03pacxe. V /KCHIUHH Go/ibiiiHHCXBOcnynaeB saGojieBaHHa npuxo^Hxoi na B03pacx ox 25 40 34 jiex, B 3XOM BO3pacxeHcenmHHbi Gojreiox name MJOKHMH.
B CBJI3H c BbicoKOH pacirpocxpaHeiiiiocxwo xy6epKyjie3a B HameMcxpane npo6i:eMa KpoBoxeneoHH H KpoBoxapKaHHj* y GojibHbix xyGepxyjiesoMoco6eHHO aKxyajibHa. reMocxaxH4ecKaa xepanun neroHHbix KpoBoxeneHHHHBJisexca Heoxx>eMJieMOH nacxbio KOMiuieKciiOH naxoreHexHHecKOH xepanwH, rjieOCHOBHOH KOMnOHCHX - Me^HKa.\ieHXO3HOe CIIM>KCHHe ^aBJieHHM B MaJIOM H
GojibiiioM Kpyre KpoBoo6pamcHMH c npHMCiieHHCM ranrnHoGjioKaxopOB HHxpaxoeH 6jlOKaXOpOB KaJIbUMCBblX KEHajIOli.
B pa3BHXHH jieroHiibix KpoBOTeneiiMH H KpOBOxapKaHHH y 6ojibHbixxy6epKyjie3OM onpeziejieanoc snaneHHe npH^aexcn cHcxeMe cseprbiBaHHaH 4)H6pHHOJTH3a. H3BCCTHO, HTO TKailh JICFKOrO COZiep^CMX BblCOKOaKXHBHblH
xKaHCBOH xpoivi6onjiacxHn, ynacrBycx a CHHTCSC renapHHa,HCXOHHHKOM xKaHeBoro aKXHBa'ropa npo([)M6pHnojiH3HHa, B
(f)H6pHHOJTIX3a (II. C. Py-CCHKHH, 1973). CKJIOHHOCXb K JierOMHbIM
H KpOBOXapKailHHM 06tMCHHIOT HeAOCXaXOHHOCXbK) CHHX63a
npoxpoivi6HHa nenenbio, a xaK >KC 4>aK'ropa XareMana (1961), A. M. MaKHHCKMH,F. C. A3H3OB (1972) 6ojibiiie ripM;iaBaJin snaneHHsi 4)yHKUMOHajibHOHHC^OCXaXOMHOCXH XpOMGoilHTOB, KOTOpafl XapaKXCpMSOBaJiaCb CHH>KeHHeM
xpoivi6o njiacxMHOMHoro (J)aKxopa. ^pyrMC anxopbi (H. M. PsaeB, A. H.MaKHHCKHH, 1970; JI. B. Xy;i3HK, 1978) ycxaiioBMJTH cHH^CHne aKXHBHOcxn XIII4>aKxopa, BCJie^cxBHe Hero crycxoK ()iH6pHHa o6pa30BbiBaexc5i 6bicxpo, HOocxaexca pbixjibiM 113-33 tie/iocxaxKa aKTMBHocxn XIII (J>aKxopa njia3Mbi((J)H6pHHa3bi), Koxopbifi yKpciuisicx ero cxpyKxypy. F. B. CyxblpHHa (1967), Brnn,Beraon (1967); A. B. LLIeMcxoB (1968); H. M. OoMHHeBa (1974) B 6ojibiiiHHCXBe
HauuiM 4)H6pnHOJiHXHHecKyio aKXHBiiocxb njia3Mbi B MOMCHX neroHHbixH KpOBoxapKaiiHii uoBbiiiieniiOH. TxaHb jierKoro
6ojibiuoe KOJIMHCCXBO aKTHBaxopa npo<}>H6pHHOJiH3HHa, MecxHoKoxoporo MO^cex npHBecxw K pac rBopcuHio 4}H6pHHOBoro crycxKa,o6pa3OBaBmeroc$i na MCCTC noBpe>K;icunoro cocy^a, BCJie/icxBue HeroBO3HMKHyXb KpOBOXeHeilliC. McXO;jH H3 3TOrO, F. C. HCBepOB (1967) H3y4HJl
(j)H6pHHOJIHXH4eCKyK> aKTHBIIOCTb MOKpOTbl MCXO^OM ({)H6pHHOBbIX HJieHOK H
HaiUeJI, HXO 4)K6pHHOJTHXHHeCKa5l aKXHBHOCXb MOKpOXbl y 6oJl!>LlIHHCXBa 6oJTbHbIX
c KpoBoxapKaniieivi Bbicoxaa H B concxaiiHH c ^pyrHMH 4)aKxopaMH co3aaexnpe/inocbijiKH A^a 4JiHxejibiioro KpOBoxapKaiiMM. flajiee JI. B. Xy,U3HK, B. M.CH6Hp>TKOB, JI. A. VcaMCBa (1971), conoc'raBnaa nojiynenHbieHCCJieZl,OBaHHH 4)H6pHIIOjrHXHMCCKOH aKXHBHOCXH IIJia3MbI H MOKpOXbl,
ycTaHOBHJiH, HXO y 6ojibiibix xy6epKyjie3OM jierKHx iiaGjii4)M6pHHOJlMXHHeCKOH aKXHBHOCTH HJiaSMbl M MOKpOXbl. OcoGeHHO OHH Bblpa>KeHbI
npH ^ecxpyKXHBHOM xy6epKyjie3c, OCJIO>KIICHHOM JieroHHbiM KpOBoxeneHHCM HKpOBoxapKaubCM. JI. B. Xy;i3HK (1977) cnHxaex, qxo B naxoreH63e jieroHHbix
KpoBoxeneHHH H KpOBoxapxaHHH cymccTBCHHoe 3HanenHe HMeioxjioKanbHoro 4)H6pnnojiM3a B nopa>KeiiHOM ynacxKe jiencHx, cnn^eHHe aKXMBHocxHXI 1 1 (JiaKxopa H ranepxeH3H>i cocyflOB Manoro Kpyra KpOBOo6pameHHH.
B KOMnJieKCHOM JICHeHHH JlCFOHHblX KpOBOTeH6HHH H KpOBOXapKaHHH
npH Ty6epKyjie3e Heo6xoziHMo ynnxbraaxb jiamibie KoarynorpaMMbi HxpoM6o3JiacxorpaMMbi, xaK KaK npn BBejieiiHH c reMOcxaxunecKOH nejibio XOJILKOKoaryji^HxoB (xjiopucxbiH KanuuHH, BHKacoJi H up.) ne yHHXbiBaexcn (J)H3HOJiorHHnpouecca CBepxbiBanHH KPOBH, oco6einiocxH 4)apMaKOJiorHHecKoro AeHCTBMHKoarynaHTOB H naTorenes Jicroniibix KpOBOTeneiiMH H KpoBOxapKaHHH. HCXOAH M3MexaHMSMa ^opMiipOBaHHa crycTKa, HX oc'ranoBKa .uojmHa npOBO/inxbOi HexojibKo KoaryjiaHTaMH, HO M HHrwGHTOpaMH (j)H6pHHOjiM3a (cHHxexHHecKneaMHHOKHCJIOXbl — 3HCHJIOIiaMHHOKaHpOlIOBaM,
aMHHOMexHJiUHKoreKcaHKap6onoBasi; H uemecTBa >KHBOXHoro M pacxHxejibHoronpOHCxo^c/ieHHa - Tpacujioii, najioji, HiiHnpoJi, Koirrpn-Kaji, iinrHxpHJi) - JI. B.Xyfl3HK(1977).
npencxaBJiaex HHxepec UOSMO^KHOCTB 6bicxpOH H acjxfjeKXHBHOHocxanoBKH KpOBOxeneHMH H3 JierKMX c HcriojibsoBaiineM oxenecxBeHHoroaHXH(J)H6pHHOjiHXHHecKoro npenapaxa xpaHCKcaMOBOH KHCJIOXBI «TpaneKcaM», BKanecxBe KOMnoneHxa KOMnJieKcuoH xepanHH.
TpaneKcaMOBaa KHCjioxa (TpaneKcaM) - o6na^aexAHTH(J)H6pHHOJTMTHHeCKHM, IlpOTMBOaJlJlCprMMeCKHM, IIpOXHBOBOCnaJlHXeJlbHblM
^eHCXBHCM. TpaHCKcaMOBasi KHCJiora HiirHGnpyex aKXHBaxopbi nuasMHHorena Hnjia3MHHa H noflaBJiMex o6pa3OBaiiHe KHHHHOB M /ipyrnx nenxn^OB, yMacxByioujHxB BocnajiHxejibHbix H ajxncprHLiecKHX peaKunsix.
FeMOCXaXMHeCKHH '3(J)C|)CKT XpaHCKCaMOBOH KHCJlOXbl oGyCJlOBJlCH
xpOM6oij,HxapHbix npoGoK B noBpoiuicinihix cocyziax. DoziaBJieHMe (J)H6pHHOJiH3aocHosaHO na KOHKypenxHOM xopMO>KeiiHsi HJia3MHiioreHaKXHBHpyiomero4>epMeHxa H yrnexenHH o6pa3OBaHHH njiasMHua. HpHMeHeHHe xpaneKcaMOBOHKHCJlOXbl OCOGeilHO 3^^CKTHBHO IlpH HaXOJlOrHHCCKHX COCTO3HHHX C
XapaKxepIi3yK)lHHXC)l (JmGpHIIOJIMXHHeCKOH aKXHBHOCXH B KpOBH H XK3H5IX, B XOM
HHCJie HpH XHpypFHHeCKHX OIiepailHHX. MlIOrOHHCJieHHbie HCCJie/IOBaHHM
noKasajiH oxcyxcxBHe y xpancKcaMOBOH KHcuoxbi xporviGoreHHOH aKXHBHOCXH.TpaneKcaMOBan KHcnoxa HPHMCHMCXCM B MMpe c 1964 rojia. H3BecxHo, HXO ee34>(j)eKXHBHOCXb M 6e3onacnocxb B 20 pas npeBbimaex anajrorHHHbie noKasaxejin3HCMJlOH-aMHHOKanpOHOBOH KMCJIOTbl.
LJ,ejib HCCJie^oBaiiHM.CpaBHeHHe reMOcxaxHHCCKoro ;ICMCXBHM TpaneKcaM (xpaHeKcaMOBOH
KHCJlOXbl) H anCHJlOH-aMHHOKailpOHOBOH KHCJlOXbl y GoJlbHblX C KpOBOXapKaHbCM,
BO3HHKuieM Ha (J)OHe 3a6ojieBaiiHH JICFKHX. CpaBiieiiHe xapaKxepHCXHKoGonx BH/IOB jieneiina.
BbiJio npoBe^ieiio paH;ioMH3MpoBainioe cpaBHHxejibHoe nccjieziOBaHHerpynn nauneHTOB, no 30 B Ka/K/jon, rocnnxajiHSHpoBaHHbix B TKB X»7 no
KpOBOxapKaHba. KpHTcpHaMH BKJiiOHeiiHH 6bijiH:
C KpOBOXapKaHbCM, pa3BHBlIIHMC5I Ha CJ)OHe
iio/iTBep/K/ieiinux 3a6ojieBaHHii JICFKHX:HecKafl 6ojie3Hb, paK nerKoro, ry6epKyjie3 Jiencoro,
nHCBMOHHfl
BospacT 18-80 JICTMy>KHHHbi H ne GepeMCHHbie ne KOPMHIUHC 5KeHinHHbi
HCKJI1OHCIIHM GbUIH!
HyBCTBHTCJibHocxb K HCCjiejiyeMbiM npenapaxaM• TopM03bI M TpOM6o3M6oJlHHeCKHC OCJlO^CHeHH« y naUHCHTOB
• TpOM603M6oJIH>I JICFOHHOH apTCpHH
• He jieroHHbie iipHHMiiw KpoBoxapKansa• HapymeHHe 4>yHKi^HH DOHCK (KpeaxnnHH B cbiBOpoxKe KPOBH
MCHee 25 MF/JI)• HapymeHHe (J)yHKHHH ncHCHH (ACT HJIH AJ1T Gojibiiie 3-x
B nepByio rpynny liKJiioHeiibi nauneiiTbi, KoxopbiMTpaHCKcaMOBOH KHCJIOTOM B jiose 1 000 Mr BHyxpHBeHHO xpH^K^bi B cyTKH
c HHTepBajiOM 8 nacoB (OOO «MMP-OAPM», POCCHH) ^o HOJIHOH ocTaHOBKHKpOBOTeHCHHfl.
B KOHTponbHOH rpyuiie JieneiiMe npoBo;jHJiocb ancHJion-aMHHOKanpOHOBaa KHCJIOTOH , 5% patrmop 100 MJI (npoH3Bo^CTBa MXOH HM.CeMaiiiKo, POCCHS) ^o UOJIHOM oc'ranoBKM KpoBOTeneHHii.
Pan^oMM3auHH npOBOjiHJiacb GjioxaMH no 10 nauneHTOB, BcooTBexcTBue c KOMnbioxepnoH CXCMOH (wvvw.randQmlzation.com).
OueHKa 3$$eKTHBHOCTH npoBoztHJiact nocjiejiyiouiHM1 . BpeMfl, B TeneiiHe Koroporo 6tuio KynnpOBaHO2. HOTpeGliOCTb B OIICpaTHBIIOM J1CHCHHM
OueHKa 6e3onacHOCTH npoeo^HJiacb no iiajiHHHio HJIH oTcyxcTBHK)Tporvi6oTH4ecKHx, ajiJieprHHccKHx H jipyrnx ocno>KHeHHii.
CxeMa Ha6jno/ienH« 3a iianHeiiTaMH BKJiioMajia B ce6n:• OUCHKy 3CJ)(})CKTHBIIOCTH
A. E>Ke;iHeBiioc KoaryjionorHHCCKOcB.C. HBD.E. AMTB• oueHKy 6e3onacnocTH nenpcptiBHo1. HccjienoBaHHe MHO
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(091-58)HI9'£9'8Z6'/,9BDBh f£ F-Od
( I S I - 8 0 1 )6119'£
f ' lA5^KHHOhOIf O
WBDHOIIBdx
hBH£ HITOXOH XO % Q
BDBh p"£ B£ 9HH3M<MH3
DgB a BOBh pi B£ 9HH3JKHH3
(HHHSlfCHirgBH %)
BDBh pi B£ 3HH3^CHH3
EH EXHSllQ
(HKHXdBaM) BHBHl/9]/^
% Hsmiqaou% BwdoH
% HS^HH^
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(HITHXdBa^BHB^W
% Hsmiqaouo/0 BwdoH
O/ H3M/l/fU'~\Q rltJ^r-Wrl 1
\t
of i -on ^^dopiHHgOITJOW9J
BHHgoir.iows.i
2.HoKasaxejiH reMaxoKpHTa
FCMaXOKpHX
Hopivia
1 rpynna -rpai-ieKcaM
N=30
II rpynna -KOHTpOJIb
N=30
J\O J I C H C H M M
CHH^CCH %
Hopivia %
OoBbiiueH %
Me^Hana (KBapxnjiH)
40%
60%
0
33,78
(24,9-41,5)
38%
62%
0
35,4(33,7-36,1)
Hepes 24 naca
CHH^CCH %
Hopivia %
ROBLIIUeH %
Me^Hana (KBapxHJin)
50
50
0
31,9(21,3-42,5)
65.5%
33,5
0
27,2(25,7-30,1)
OueHKa M3MeiienMH 3a 24 naca
CHM^eHHe 3a 24 naca
(% Ha6jTIO^eHHH)
CHH^ceHHe sa 24 naca B a6c.3Han - Meanana (KBapTHJin)
CHH>KeHHe 3a 24 naca
B % OT HCXO^H. 3naH.
70,3
5(1 ,5-7 ,45)
14,5
(5,0-21,2)
90
7,7(5,6-8,6)
22,7(15,7-23,8)
MeHee Bwpaxceiiiioc CHH^KCHHC ypoBiia reMaxoKpHTa Ha cj)OHe npnervia
npenapaxa TpaneKcaM, no cpaBiieitHio c rpyiinoii IFICHJIOH aMMHOKanpOHOBOH
KHCJTOXbl.
Ta6jiHna 3. HoicasaxejiH MHO
MHO
HopMa 0,800- 1,1 40
I rpynna-xpaiieKcaM
N-30
II rpynna -KOHXpOJIb
N-30
}[o JICHCHHM
CHH^CCH %
Hopiua %
HoBbiineH %
Me/mana (KBapxMJin)
-
20
80
1,26
(1,08-1,59)
-
20
80
100,6(1,08-1,59)
Hcpes 24 naca
CHH)KeH %
Hopiua %
HoBbiineH %
Me^HaHa (KBapxHJiH)
7,1
75
17,9
1,28(0,93-1,87)
40
50
10
1,10(0,78-1,51)
OueHKa H3MeHeiiHH 3a 24 Haca
CniDKeHne 3a 24 Haca
(% Ha6jIK),ZieHHH)
CHH^KCHHC 3a 24 Haca B a6c3Han - Meanana (KBapTHJiii)
CHH^eHHe 3a 24 Haca
B % OX HCXOZIH 3HaH
89,3
6,6(2,4-13,9)
6,7(2,25-13,4)
100
8,25(6-13,4)
8,31(6,2-14)
MHO (MOKAyHapozjHoc nopMajiH30BanHoe oxnomeHHe) - xecx,no3BOjmomHM HanGojiee TOHIIO O U C H M i b pcsyjibxaxbi npoxpoiviGHHOBoroH HH^eKca, H cJie^OBaxejibiio, COCTOMIIHC cBCpXHBaioincM CHCTeivibi KpOBH. BHacxoittuee Bpeivia MHO JIBJIHCXCH «3OJioxbiM CTanjiapxoM» B ouenKe3(^(J3eKTHBHOCXH H 6e3onacnocxH JICHCIIMH.
KaK BH^HO H3 xa6jiHiibi, ua (J)onc JICHCHHJI TpaneKcaMOM PHCKxpOM6oxHHecKHx ocjio>KiieiiHM (no ; iauifbiM MHO) ne Bbipa^en, HXO
no4XBep>K,aaex jinxepaxypiibicxpanexcaMOBOH KHCJIOTLI.
o oe^onacnocxH
Ta6jiHua 4.1 IoKa3axejiH
TpOM6oiiHXbi
HopMa 180-320
I rpynna -rpancKcaM
N=30
II rpynna -KOHXpOJlb
N=30
l\O J IC4CI IHM
CHH^CCH %
HopMa %
HoBbimeH %
Me^Hana (KBapxHJin)
53,6
42,9
3,6
316,09(154-520)
51,4
48,6
-
280,8(179-360)
Hepes 24 naca
CHH^eH %
HopMa %
HoBbimeH %
Me^naHa (KBapxiuiw)
53,6
39,3
7,1
323,45(177-510)
30
50
20
234(169-263)
OueHKa M 3 M C I I C H M M 3a 24 Haca
CnH)KeHHe 3a 24 naca
(% Ha6jiio^eHHH)
CHH>KeHHe 3a 24 Haca B a6c3nan - Me^wana (KBapxHJin)
CHHacenne 3a 24 Haca
B % OX HCXO^H 3HaH
71,6
6,55 (-8,5)- (23)
5,8(~3,9)-(13,5)
40
-5,5
(-49)- (30)
-4,2
(-22,9) -(11, 5)
Ha 4»one npneMa npenapaxa oxMCscubi pa3nonanpaBJieHHbie H3MeHenn»
noKasarejieii. Bo BxopoM (anciuiOH-aMHHOKanpOHOBaa Kncjioxa) rpynne B
OXMCHCHO He6ojibixioe yBejiMHennc ypoBiui c GOJIMIIHM pasGpocoM, B OCHOBHOH -
He6ojibiuoe cHH^KCHHe napaivicxpa, TO>KC c GojibmviM pa36pocoM.
10
Ta6jmua 5. IIoKasaTenH AHTB
AMTB
HopMa 28-43
I rpynna -TpariCKcaM
N-30
II rpynna -KOHTpOJlb
N-30
1(0 J ICHCHHM
CHIDKCH %
HopMa %
HoBbimeH %
Me^Mana (KBapTHjra)
64,3
35,7
-
27,82(19,3-29,7)
68,5
41,5
-
25,05(23,2-27,6)
Hcpe3 24 naca
CHPDKCH %
HopMa %
noBbimeH %
MejiHana (KBapTHJin)
42,9
60,1
-
27,59(24-30,6)
70
30
-
27,4
(21,5-28,7)
qacTHHiioe TpOM6onnacTHHOBoe BpeMa HJIM AHTB3xo BpeMJi, sa KOTOpoe oGpasycTCJi crycroK KpoBH nocjre npiicoe^HHeHHa K
xjiopM^a Kajibuna H ^pyrnx peareiiTOB. AHTB - naii6ojieenoKa3aTeJib cBepTbmacMOCTH KPOBH, onpe^ensieMbiM npH
cHCTeMbi reMOcrasa. Mcxo;_ino HHSKHC 3HaneHHH riapaMexpOB Bo6enx rpynnax neMHoro no^pocjm na (})oiic
B rpynne nauneHTOB, nojiyqaiimnx jieneiiHe TpaneKcaMOM, HoprviajiM3auHsireMocxasa B TeneiiHe cyTOK BcrpenaeTca y 6ojibmero nncjia 6o^bHbix.
1 1
1. 3(J)4)eKTHBHOCTb TpaHeKcaMa B KOMmieKCHOH xepanHH jieroHHbixKpoBoxenemiH cymecxBCHHO Bbime, HCM y anciijioH-aMHHOKanpoHOBOH KHCJIOTW,KaK no ^aHHtiM KJiHHHHecKoro Ha6jiK>fleHHa, xaK H no /jaimbiM AHTB.
2. EesonacHocxb xpaneiccaMa o6ycnoBJiena Kax OXCVXCXBHCM BJIHHHHH HaTpOM6oo6pa3OBanHe, xaK H sa CHCT 6ojiee 6bicxpOH HopMajiHsaijHH reiuocxasa ,HTO 6bijio noKa3aHO B
3. HpenapaT TpaneKcaivi B KOMnjieKCHOH repanHH jieronHbixaBJiHCTca npenapaxoM BbiGopa, nosBOJisnomHM Ha^e^KHO H 6e3onacno ocxaHOBMTbjieroHHoe
4. HpHMeHeHHe npenapaxa TpaneKcaM coKpamaex nacxoxy onepaxuBHorojieroHHbix
Jlnxepaxypa1. Andersson L, Nilsson IM, Nilehn J-E, et al. Experimental and clinical studies onAMCA, the antifibrinolytically active isomer of p-aminomethyl cyclohexanecarboxylic acid. Scand J Haemal 1965;2:230-47.2. Bartholomew JR, Salgia R, Bell WR. Control of bleeding in patients withimmune and nonimmune thrombocytopenia with aminocaproic acid. Ann InternMedl989; 149:1959-1961.3. Can drugs reduce surgical blood loss? (editorial) Lancet 1988; 1:55-56.4. Coulter A., Kelland J., Long A. the management of menorragia. Effectivehealth Care Bull. 1995; 9: 1-14.5. Kobrinsky NL., Israels ED, Gerrard JM et al. Shortening of bleeding time by 1-deamino-8-D-arginine vasopressin in various bleeding disorders. Lancet 1984;1:1145-1148.6. Mannucci PM, Vicente V, Alberca I et al. Intravenous and subcutaneousadministration of desmopressin (DDAVP) to hemophiliacs: pharmacokinetics andfactor VIII responses. Thromb Haemost 1987; 58:1037-1039.7. Melander B, Gliniecki G, Granstrand B, et al. Biochemistry and toxicology ofAmikapron*:the antifibrinolytically active isomer of AMCHA (a comparativestudy with eaminocaproic acid). Acta Pharmacol Toxicol 1965;22:340-52.8. Okamoto S, Okamoto U. Amino-rnethyl-cyclohexane-carboxylic acid:AMCHA. A new portent inhibitor of the fibrinolysis. Keio J Med 1962;! 1:105-15.
Med 1989; 149:1959-1961.3. Can drugs reduce surgical blood loss? (editorial) Lancet 1988; 1:55-56.4. Coulter A. , Kelland J., Long A. the management of menorragia. Effectivehealth Care Bull. 1995; 9: 1-14.5. Kobrinsky NL., Israels ED, Gerrard JM et al. Shortening of bleeding time by 1-deamino-8-D-arginine vasopressin in various bleeding disorders. Lancet 1984;1:1145-1148.6. Mannucci PM, Vicente V, Alberca I et al. Intravenous and subcutaneousadministration of desmopressin (DDAVP) to hemophiliacs: pharmacokinetics andfactor VIII responses. Thromb Hacmost 1987; 58:1037-1039.7. Melander B, Gliniecki G, Granstrand B, ct al. Biochemistry and toxicology ofAmikapron*:the antifibrinolytically active isomer of AMCHA (a comparativestudy with eaminocaproic acid). Acta Pharmacol Toxicol 1965;22:340-52.8. Okamoto S, Okamoto U. Amino-rnethyl-cyclohexane-carboxylic acid:AMCHA. A new portent inhibitor of the fibrinolysis. Keio J Med 1962;! 1:105-15.
13
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