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中华产科急救电子杂志 ›› 2022, Vol. 11 ›› Issue (02) : 88 -93. doi: 10.3877/cma.j.issn.2095-3259.2022.02.005

所属专题: 指南共识

指南·标准·共识

预防妊娠相关静脉血栓国内外指南和专家共识解读与比较
黄秋雨1, 黄莺莺1, 黄启涛2,(), 刘正平3, 郭晓玲3, 钟梅1,()   
  1. 1. 南方医科大学南方医院妇产科,广州 510515
    2. 佛山市第一人民医院产科,广州佛山 528010
    3. 南方医科大学附属佛山市妇幼保健院产科,广东佛山 528100
  • 收稿日期:2021-11-21 出版日期:2022-05-18
  • 通信作者: 黄启涛, 钟梅

Prevention of venous thromboembolism during pregnancy and puerperium: comparison of domestic and foreign guidelines

Qiuyu Huang1, Yingying Huang1, Qitao Huang2()   

  • Received:2021-11-21 Published:2022-05-18
  • Corresponding author: Qitao Huang
引用本文:

黄秋雨, 黄莺莺, 黄启涛, 刘正平, 郭晓玲, 钟梅. 预防妊娠相关静脉血栓国内外指南和专家共识解读与比较[J]. 中华产科急救电子杂志, 2022, 11(02): 88-93.

Qiuyu Huang, Yingying Huang, Qitao Huang. Prevention of venous thromboembolism during pregnancy and puerperium: comparison of domestic and foreign guidelines[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2022, 11(02): 88-93.

静脉血栓栓塞症(venous thromboembolism,VTE)包括深静脉血栓形成(deep vein thrombosis,DVT)和肺动脉栓塞(pulmonary thromboembolism,PE)。与非妊娠期相比,妊娠期及产褥期发生VTE的风险显著增加,是国内外孕产妇死亡的重要原因[1]。我国2018年的妇幼卫生监测数据显示,孕产妇死亡率已经从2000年的53/10万降至2018年的18.3/10万,其中栓塞性疾病是我国孕产妇死亡的第七大原因,占3%,并且VTE是可以预防的[2]。对所有孕产妇进行VTE早期评估、早期预防,对于降低孕产妇血栓的发病率至关重要。目前,不同国家的学术组织已经发表了关于妊娠期和产褥期静脉血栓性疾病危险因素评估和预防措施的指南或专家共识,各版指南或专家共识既有共同点,又存在差异之处。本文对比2015英国皇家妇产科医师协会(Royal College of Obstetricians and Gynecologists,RCOG)[3]、2018美国妇产科医师协会(American College of Obstetricians and Gynecologists,ACOG)[4]、2020澳大利亚昆士兰卫生组织(Queensland Health,QLD)[5]、2020上海市母婴安全专家委员会[6]、2021中华医学会妇产科学分会产科学组[7]等公布的VTE指南及专家共识,总结了VTE的危险因素评估方法和VTE的预防措施等内容,为预防妊娠相关静脉血栓性疾病提供参考和借鉴。

表1 不同指南与专家共识VTE风险因素评分情况(分)[3,5,6]
表2 2015 RCOG指南和2020昆士兰指南对于不同体重患者使用依诺肝素预防VTE推荐剂量
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