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18.04.07
? 2007 ?. ? Annals of Internal Medicine ???????????? ???????????? ???????????? ???????? ???????? ?????? ? ????????????? ???????? ?????? ?? ??????????? ? ??????? ????????? ? ????????? ???????? ??? (???) ?????? ??????????? ? ???????? ???????? (??) [1, 2], ?????????? ?? ??????????? ????????????? ???? [3]. ???????? ???????? ????????? ?????? ????????????.

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???????????? 1. ??????????? ?? ???????? ??????????????? ??????? ?????? ?????????????? ??? ??????????? ??????????? ??????????? ?????????? ?? (??? ? ??) ? ?? ?? ?????? ??????? ???????????????? ?????????? ??????????? ??????.
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??????? ?????? ??? ??????????? ??? (Wells P.S., Anderson D.R., Bormanis J., et al. Value assessment of pretest probability of deep-vein thrombosis in clinical management. The Lancet. 1997;351:1795-8.)
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??????? ?????? ??? ??????????? ?? (Chagnon I., Bounameaux H., Aujesky D. et al. Comparison of two clinical prediction rules and implicit assessment among patients with suspected pulmonary embolism. Am J Med. 2002; 113: 269-275)

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???????????? 2. ? ????????? ? ?????? ??????????? (???????????) ???????????? ??? ? ?? ??????????? ?-?????? ?????? ?????????????? ??????? ???????? ????????????. ?????? ???????? ?-?????? ????????????? ?????? ??????????? ??.
? ????????? ????? ???????? ????? ??????? ????????????? ??????????????? ???????? ??????????? ?-?????? ? ??? ? ?????? ??????????? ???????????? ?? (??????? ??????? ??? ????????????? ?????????, ??? ??? ???????? ??, ??? ? ???????? ?????????????????? ?????????). ????????????????????? ???????? ???????? ?????-????????? ??????????????? ?????? (ELISA), ??????? ?????????????? ???? ELISA, ??????????????????? ?????????????????? ???? (???????????????? 96–100%). ? ??????? ???????, ? ????????????? ??????????, ? ??????? ?????????????????? ????????? ??????????? ?-?????? ????? ???? ????????????? ??? ?????????? ???????? ??.
???????????? 3. ?????????????? ???????????? (???) ????????????? ? ????????? ? ????????????? ??? ??????? ??????????? ???????????? ??? ?????? ???????????.
??? ????? ????????????? ??? ??? ??????, ??????? ????????????? ??????? ??? ??? ?? ????????? ???. ????????? ??? ??? ?????????? ????? ????????????? ? ??????? ? ??????????? ?? ??? ?????? ??? ? ????????? ? ?????????? ???????????? ??? ?????????????? ?????? ???. ??????????? ?????????? ???????? ???????????? ?????? ??? ?????????? ???????? ???.
???????????? 4. ? ????????? ? ????????????? ??? ??????? ??????????? ???????????? ?? ?????????? ????????? ??????????????? ???????????????? ????????????.
???????? ?????????? ?????????????-????????????? ????????????, ????????????????? ?????????? ???????????? ?????????? (??), ??????????? ???????? ???????. ? ???????? ??????? ????????, ??? ?? ????? ???? ???????????? ????????????? ??? ?????????? ?? ? ????????? ? ??????? ??????????? ????????????.

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???????????? 1. ????????????????? ???????? (???) ?????? ????, ??? ??????????????????? ??????? (???), ?????????????? ? ???????? ????????? ??????? ???. ??? ? ??? ????????? ???????? ??? ????????? ??????? ??.
??????????? ????????, ??? ?????????? ??? ????? ??????????, ??? ???, ??? ????????? ??????? ???, ? ????????? – ??? ???????? ?????????? ? ????? ??????? ????????????. ????????? ?????????????? ????????? ??? ????? ?????? ?????? ????????????? ??? ? ???????? ????????? ??????? ??. ?????? ??????????????? ?????? ??????????, ?? ??????? ????, ????? ?? ????????????? ??? ??? ???.
???????????? 2. ?????????? ??? ? ???????????? ??????? ? ??? ??? ????????? ?? ???????? ?????????? ? ????????????, ???? ???????? ?????????? ????? ????????? ? ??????? ??????????? ???????????? ??????????.
? ??????????? ??????????, ???????????? ??????????????????? ? ???????????? ?????????, ?????????????????? ???????????? ??????? ????????? ???, ??????? ???????????? ? ??????????. ?????? ??? ???????????? ????????? ?? ?????????? ??????? ??????? ? ???????? ??????????? ????????????? ???????????? ??????????. ? ??????????? ??????? ??????????? ???????? ? ???????????? ????? ??, ????????????, ??????????? ?????????????? ?????????????, ?????????? ??????? ? ???? ? ?????? ??????????????? ? ????????????? ???????.
???????????? 3. ?????????????? ????? ?????? ??????? ?????????????? ??? ???????????? ??????????????????? ???????? (???), ??????? ? ??????? ?????? ??????????? ??? ? ??????? ??? ??????? ?????? ????.
???????? ???????????????? ????????????? (???????? ??????? ? ??????? ???) ??? ??????????????, ??? ? ????????? ?? ????? ?????????????? ?????, ???? ?? ????????????? ???????? ? ??????? 1 ?????? ?? ????????? ?????????????? ???. ??????????? ??????? ??? ??????????? ? ??????? ?????? 2 ???.
???????????? 4. ????????? ?????? ?? ????????? ???? ????????????? ???????????? ?? ???? ???????????????? ??????? ? ?????????? ??????.
?????????? ?????? ???????? ?????????? ?????????? ???????????? ???????? ?, ????? ??????? ?????? ? ???????????? ????? 6 ? 12 ???????? ???????? ? ?????? ???????????? ? ????? ?? ????? ?????. ?? ???, ?? ??? ?? ????????? ????? ???????? ? ?? ??????? ? ?????? ??????????? ? ?????????? ????????????.
???????????? 5. ???????????????? ??????? ?????? ???? ????????? ?? ???? ?? 3 ?? 6 ??????? ? ??? ? ??????????? ????????? ????? ? ????? 12 ??????? ??? ?????????????? ??. ??????????? ????????????????? ??????? ??? ??????? ? ?????????????? ??? ?????????????? ?? ?? ??????????, ?????? ??????? ?????????????? ? ??????? ????????????? ?????????? ???????????????? ???????.
? ????????????? ? ???????????????? ????????, ?????????????? ?? 4 ???, ? ??? ? ?????????????? ? ?????????????? ?? ???????? ???????? ?????????????? ????? ???????? ?? ? 64% ?? 95%. ????????? ????/????????????? ??? ??????? ????????????????? ??????? ?? ???????????.
???????????? 6. ?????????? ??? ????????? ? ?????????? ??? ?????????? ??????? ?? ? ?????????? ??????? (? ????? ???? ???????????????? ????? ??????? ? ??????? ?????????).
? ????????????????? ?????????? ????????, ??? ??? ??????????? ?? ????????????? ? ????????? ???????????????? ??? ??????????? ??????? ?? ? ?????????? ?????????. ??? ????? ??????????? ? ??????? ? ?????? ??????????? ????????????? ??????????????? ?????????? ?, ????????, ????? ?????????? ? ????????? ? ?????.

?????????.
1. Qaseem A., Snow V., Barry P. et al. Current Diagnosis of Venous Thromboembolism in Primary Care: A Clinical Practice Guideline from the American Academy of Family Physicians and the American College of Physicians. Ann Intern Med. March 20, 2007;146:454-458.
?????? ????? ??????. Medline ????????.

2. Snow V., Qaseem A., Barry P. et al. Management of Venous Thromboembolism: A Clinical Practice Guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. Feb. 6, 2007;146:204-210.
?????? ????? ??????. Medline ????????.

3. Segal J.B., Streiff M.B., Hoffman L.V. et al. Management of venous thromboembolism: a systematic review for a practice guideline. Ann Intern Med. Feb. 6, 2007;146:211-22.
?????? ????? ??????. Medline ????????

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