Как исключить тромбоз глубоких вен на уровне первичного амбулаторного звена?

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§Є§г§г§Э§Ц§Х§а§У§С§д§Ц§Э§Ъ §а§б§в§Ц§Х§Ц§Э§Ъ§Э§Ъ §У§Ц§в§а§с§д§Я§а§г§д§о §ґ§¤§Ј §б§в§Ъ §в§С§Щ§Э§Ъ§й§Я§н§з §г§и§Ц§Я§С§в§Ъ§с§з §б§а§Х§г§й§Ц§д§С §г§е§Ю§Ю§н §Т§С§Э§Э§а§У. §µ §б§С§и§Ъ§Ц§Я§д§а§У §г§а §г§й§Ц§д§а§Ю < §Ъ§Э§Ъ = 3 §Т§С§Э§Э§а§У §б§в§Ъ §Ъ§г§б§а§Э§о§Щ§а§У§С§Я§Ъ§Ъ §д§а§Э§о§Ь§а §Ь§Э§Ъ§Я§Ъ§й§Ц§г§Ь§Ъ§з §Ь§в§Ъ§д§Ц§в§Ъ§Ц§У (§Т§Ц§Щ §а§б§в§Ц§Х§Ц§Э§Ц§Я§Ъ§с D-§Х§Ъ§Ю§Ц§в§С) §ґ§¤§Ј §Т§е§Х§Ц§д §б§в§а§б§е§л§Ц§Я §е 9,6% §Т§а§Э§о§Я§н§з. §¦§г§Э§Ъ §У§в§С§й §Т§е§Х§Ц§д §Ъ§г§б§а§Э§о§Щ§а§У§С§д§о §д§а§Э§о§Ь§а §д§Ц§г§д §Я§С D-§Х§Ъ§Ю§Ц§в (§Т§Ц§Щ §Ь§Э§Ъ§Я§Ъ§й§Ц§г§Ь§Ъ§з §Ь§в§Ъ§д§Ц§в§Ъ§Ц§У) §Ъ §У §г§Э§е§й§С§Ц §а§д§в§Ъ§и§С§д§Ц§Э§о§Я§а§Ф§а §в§Ц§Щ§е§Э§о§д§С§д§С §Я§Ц §Я§С§б§в§С§У§Ъ§д §б§С§и§Ъ§Ц§Я§д§С §Я§С §µ§©§Є, §Х§Ъ§С§Ф§Я§а§Щ §ґ§¤§Ј §Т§е§Х§Ц§д §б§в§а§б§е§л§Ц§Я §У 3,4% §г§Э§е§й§С§Ц§У. §µ §Т§а§Э§о§Я§н§з §г §г§е§Ю§Ю§а§Ы §Т§С§Э§Э§а§У > §Ъ§Э§Ъ = 4, §а§г§Я§а§У§С§Я§Я§а§Ы §д§а§Э§о§Ь§а §Я§С §Ь§Э§Ъ§Я§Ъ§й§Ц§г§Ь§Ъ§з §Ь§в§Ъ§д§Ц§в§Ъ§с§з, §У§Ц§в§а§с§д§Я§а§г§д§о §ґ§¤§Ј §г§а§г§д§С§У§Ъ§д 35,9%; §е §б§С§и§Ъ§Ц§Я§д§а§У §г §г§е§Ю§Ю§а§Ы §Т§С§Э§Э§а§У ЎЭ4 §б§в§Ъ §Я§а§в§Ю§С§Э§о§Я§а§Ю D-§Х§Ъ§Ю§Ц§в§Ц ЁC 23,5%, §б§в§Ъ §б§а§Э§а§Ш§Ъ§д§Ц§Э§о§Я§а§Ю D-§Х§Ъ§Ю§Ц§в§Ц ЁC 42,6%.

§Ј§н§У§а§Х§н

§Є§г§г§Э§Ц§Х§а§У§С§Я§Ъ§Ц §б§а§Ь§С§Щ§С§Э§а, §й§д§а §Ъ§г§б§а§Э§о§Щ§а§У§С§Я§Ъ§Ц §б§в§а§г§д§а§Ф§а §Ь§Э§Ъ§Я§Ъ§й§Ц§г§Ь§а§Ф§а §б§в§С§У§Ъ§Э§С, §Х§а§б§а§Э§Я§Ц§Я§Я§а§Ф§а §Т§н§г§д§в§н§Ю §Ь§С§й§Ц§г§д§У§Ц§Я§Я§н§Ю §д§Ц§г§д§а§Ю §Я§С D-§Х§Ъ§Ю§Ц§в, §б§а§Щ§У§а§Э§с§Ц§д §е§Ш§Ц §У §е§г§Э§а§У§Ъ§с§з §б§Ц§в§У§Ъ§й§Я§а§Ф§а §С§Ю§Т§е§Э§С§д§а§в§Я§а§Ф§а §Щ§У§Ц§Я§С §г §У§н§г§а§Ь§а§Ы §д§а§й§Я§а§г§д§о§р §Ъ§г§Ь§Э§р§й§Ъ§д§о §Х§Ъ§С§Ф§Я§а§Щ §ґ§¤§Ј §Ъ, §д§Ц§Ю §г§С§Ю§н§Ю, §Я§Ц§а§Т§з§а§Х§Ъ§Ю§а§г§д§о §Х§С§Э§о§Я§Ц§Ы§к§Ц§Ф§а §а§Т§г§Э§Ц§Х§а§У§С§Я§Ъ§с §б§в§Ъ§Ю§Ц§в§Я§а §б§а§Э§а§У§Ъ§Я§н §б§С§и§Ъ§Ц§Я§д§а§У §г §б§а§Х§а§Щ§в§Ц§Я§Ъ§Ц§Ю §Я§С §Х§С§Я§Я§а§Ц §Щ§С§Т§а§Э§Ц§У§С§Я§Ъ§Ц.

§¬ §Я§Ц§Х§а§г§д§С§д§Ь§С§Ю §Ъ§г§г§Э§Ц§Х§а§У§С§Я§Ъ§с §г§Э§Ц§Х§е§Ц§д §а§д§Я§Ц§г§д§Ъ §Ц§Ф§а §Я§Ц§в§С§Я§Х§а§Ю§Ъ§Щ§Ъ§в§а§У§С§Я§Я§н§Ы §Х§Ъ§Щ§С§Ы§Я (§а§д§г§е§д§г§д§У§Ъ§Ц §Ь§а§Я§д§в§а§Э§о§Я§а§Ы §Ф§в§е§б§б§н) §Ъ §Х§Ъ§С§Ф§Я§а§г§д§Ъ§Ь§е §б§а§г§Э§Ц§Х§е§р§л§Ъ§з §д§в§а§Ю§Т§а§п§Ю§Т§а§Э§Ъ§й§Ц§г§Ь§Ъ§з §г§а§Т§н§д§Ъ§Ы, §а§г§Я§а§У§С§Я§Я§е§р §д§а§Э§о§Ь§а §Я§С §Ь§Э§Ъ§Я§Ъ§й§Ц§г§Ь§Ъ§з §г§Ъ§Ю§б§д§а§Ю§С§з. 

BЁ№ller H.R., ten Cate-Hoek A.J., Hoes A.W. et al. Safely Ruling Out Deep Venous Thrombosis in Primary Care. Ann Intern Med. February 17, 2009;150:229-235.

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