Периферически имплантируемый центральный венозный катетер: обзор литературы

Л.В. Цепенщиков, В.К. Лядов

ФГУ «Лечебно-реабилитационный центр», Москва, Российская Федерация


РЕФЕРАТ

Периферически имплантируемый центральный венозный катетер (PICC) — это малоинвазивное устройство для обеспечения длительного центрального венозного доступа. Катетер размещается на внутренней поверхности плеча, уменьшает риск осложнений и обеспечивает возможность амбулаторного лечения пациентов. Данная публикация представляет обзор литературы о типе катетеров, применяемых в основном в онкологической практике и, к сожалению, широко не используемых в Российской Федерации. В обзоре описаны все возможные варианты и характеристики PICC, показания и противопоказания к имплантации, профилактика и лечение осложнений.


Ключевые слова: периферически имплантируемый центральный венозный катетер, PICC, ЦВК

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ЛИТЕРАТУРА

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Эффективность трансфузий тромбоконцентрата при острых миелоидных лейкозах в период проведения стандартной индукционной химиотерапии

Б. Даваасамбуу1, С.В. Грицаев2, Т.В. Глазанова2, С.А. Тиранова2, Н.А. Потихонова2, И.С. Мартынкевич2, А.В. Чечеткин2

1 ГБОУ ВПО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» МЗ РФ, Санкт-Петербург, Российская Федерация

2 ФГБУ «Российский научно-исследовательский институт гематологии и трансфузиологии ФМБА России», Санкт-Петербург, Российская Федерация


РЕФЕРАТ

Эффективность трансфузий тромбоконцентрата (ТТК), несмотря на принципиальную роль иммунных механизмов, в большинстве случаев зависит от таких факторов неиммунной природы, как лихорадка, сепсис, синдром диссеминированного внутрисосудистого свертывания, спленомегалия и др. Целью данного исследования было выделить клинико-гематологические параметры, связанные с эффективностью ТТК у больных острыми миелоидными лейкозами (ОМЛ) при проведении индукционной химиотерапии (ХТ) по схеме «7+3». Для этого у 41 больного (медиана возраста 42 года) анализу подвергнуты показатели скорректированного прироста тромбоцитов через 24 ч после окончания ТТК, а также возраст, вариант ОМЛ по классификациям ВОЗ и ФАБ, вариант прогноза по шкале ELN, характер ответа на ХТ. ТТК считали эффективной, если скорректированный прирост тромбоцитов был не менее 4,5 ´ 109/л. Больные были распределены в две группы: с эффективностью ТТК ³ 50 или < 50 %. Между группами больных не выявлено значимых различий по возрасту, вариантам ОМЛ по классификации ВОЗ, характеру ответа на ХТ и медиане общей выживаемости (ОВ). Вместе с тем в группе с эффективностью было больше больных ОМЛ с миелобластами типов M1 и M2 по ФАБ-классификации. Среди пациентов с эффективностью ТТК < 50 % было больше случаев ОМЛ с бластными клетками моноцитарной природы типов M4 и M5 по ФАБ-классификации (= 0,001). Одновременно была выявлена тенденция к снижению медианы ОВ у больных с числом тромбоцитов в крови до начала трансфузионной терапии менее 10 ´ 109/л: 6,5 vs 10 мес. при исходном числе тромбоцитов более 10 ´ 109/л (= 0,049).


Ключевые слова: острые миелоидные лейкозы, индукционная терапия «7+3», трансфузии тромбоконцентрата

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