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Научно-практическая ревматология

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Периоперационное ведение больных ревматоидным артритом

https://doi.org/10.14412/1995-4484-2014-366-375

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Аннотация

В статье рассматриваются рекомендации по совместному ведению больных ревматоидным артритом, нуждающихся в эндопротезировании крупных суставов нижних конечностей, ревматологами и травматологами-ортопедами. В связи с отсутствием общепринятых стандартов и рекомендаций по периоперативному ведению больных с ревматическими заболеваниями, принятых международными ревматологическими ассоциациями, в статье обобщен собственный опыт ведения пациентов с учетом международных подходов и рекомендаций разных стран. Обсуждаются подходы к оценке и снижению рисков кардиоваскулярной патологии, профилактики инфекционных осложнений, кровотечений, тромбозов глубоких вен нижних конечностей, особенности ведения больных с остеопорозом. Подробно представлен опыт ведения больных, получающих антиревматическую терапию нестероидными противовоспалительными препаратами, базисными противовоспалительными препаратами: метотрексатом, лефлуномидом, сульфасалазином, гидроксихлорохином. Даются рекомендации по ведению больных, получающих глюкокортикоиды и генно-инженерные биологические препараты (ингибиторы фактора некроза опухоли α, анти-В-клеточную терапию и ингибиторы рецепторов интерлейкина 6), в предоперационном и послеоперационном периоде.

Об авторах

В. Н. Амирджанова
ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, Москва
Россия


М. А. Макаров
ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, Москва
Россия


Е. И. Бялик
ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, Москва
Россия


С. А. Макаров
ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, Москва
Россия


М. М. Липина
ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, Москва
Россия


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Для цитирования:


Амирджанова В.Н., Макаров М.А., Бялик Е.И., Макаров С.А., Липина М.М. Периоперационное ведение больных ревматоидным артритом. Научно-практическая ревматология. 2014;52(4):366-375. https://doi.org/10.14412/1995-4484-2014-366-375

For citation:


Amirdzhanova V.N., Makarov M.A., Byalik E.I., Makarov S.A., Lipina M.M. PERIOPERATIVE MANAGEMENT OF PATIENTS WITH RHEUMATOID ARTHRITIS. Rheumatology Science and Practice. 2014;52(4):366-375. (In Russ.) https://doi.org/10.14412/1995-4484-2014-366-375

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ISSN 1995-4484 (Print)
ISSN 1995-4492 (Online)