Rehabilitation measures lead to an increase in the duration and quality of life of patients. The current trend towards intensification of the treatment process, early discharge of patients from hospital, as well as the duration of cardio rehabilitation programs, raises the question about the place of their implementation. The purpose of this work was to assess the readiness of patients who have undergone acute coronary syndrome (ACS) and coronary revascularization to undergo rehabilitation programs, including the use of remote technologies. The study was multicenter, conducted in hospitals of Ivanovo, Voronezh and Omsk, using a single original questionnaire agreed by the researchers. 232 patients were examined, including 124 patients with myocardial infarction, 59 patients with unstable stenocardia and 49 patients who underwent coronary revascularization. The results of the study indicate that the majority of patients who have undergone acute coronary syndrome and coronary revascularization are ready to undergo cardio rehabilitation programs, but, as a rule, in hospital or sanatorium environments. Only half of the interviewed patients have access to the Internet and know how to use it, and only 15% of the respondents are ready to undergo rehabilitation remotely. Remote ways of communicating with patients and monitoring the implementation of rehabilitation programs require both improving the ways of their technical support and raising awareness and training of patients to work with mobile devices and registrars.
Введение. Одним из основных клинических факторов риска венозных тромбоэмболических осложнений (ВТЭО), не связанных с травмой и операцией, является инсульт и/или парез нижних конечностей. Однако для пациентов с геморрагическим инсультом до сих пор нет общепринятой эффективной и безопасной схемы профилактики ВТЭО.
Цель исследования: оценка эффективности и безопасности профилактики тромбоза глубоких вен нижних конечностей и тромбоэмболии легочной артерии с помощью препарата Флюксум®.
Материалы и методы. Обследовано 60 пациентов с геморрагическим инсультом: группа 1 (n = 30) – пациенты получали препарат парнапарин в дозе 0,3 мл подкожно 1 раз в сутки ежедневно, начиная со вторых суток от момента начала заболевания; группа 2 (n = 30) – пациенты получали другие низкомолекулярные гепарины в профилактических дозах также со вторых суток от момента начала геморрагического инсульта (эноксапарин в дозе 0,4 мл 1 раз в сутки, надропарин в дозе 0,3 мл 1 раз в сутки).
Результаты. Показано, что у пациентов с геморрагическим инсультом использование нового низкомолекулярного гепарина – парнапарина (Флюксум®, Альфа Вассерманн, Италия) в дозе 0,3 мл подкожно 1 раз в сутки столь же эффективно для профилактики тромбоза глубоких вен, как и терапия другими низкомолекулярными гепаринами, при этом риск развития геморрагических осложнений не увеличивается.
Заключение. Применение препарата Флюксум® может быть приемлемой альтернативой использованию других низкомолекулярных гепаринов для профилактики венозных тромбоэмболических осложнений у пациентов с геморрагическим инсультом.
Introduction. Stroke and/or paresis of lower extremities are one of the main risks of vvenous thromboembolic complications (VTEC) not associated with trauma and surgery. At the same time, there is still no generally accepted effective and safe scheme of VTEC prophylaxis for patients with hemorrhagic stroke.
The aim of study was to evaluate the efficacy and safety of prophylaxis of deep vein thrombosis of lower extremities and pulmonary embolism with drug Fluxum®.
Materials and methods. We examined 60 patients with hemorrhagic stroke: group 1 (n = 30) – patients received Parnaparin at dose 0,3 ml subcutaneously once a day, starting from the second day after the disease onset; group 2 (n = 30) – patients received other low molecular weight heparins in prophylactic doses also from the second day after the onset of hemorrhagic stroke (Enoxaparin at dose 0,4 ml once a day, Nadroparin at dose 0,3 ml once a day).
Results. It was shown that in patients with hemorrhagic stroke the usage of a new low molecular weight heparin – Parnaparin (Fluxum®, Alfa Wassermann, Italy) at dose of 0,3 ml subcutaneously once a day was equally effective for prophylaxis of deep vein thrombosis as therapy with other low-molecular heparins, and risk of hemorrhagic complications not increased.
Conclusion. Fluxum® usage may be an acceptable alternative of other low molecular weight heparins usage for prevention of deep vein thrombosis in patients with hemorrhagic stroke.
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