妊娠相关静脉血栓栓塞症评估与预防的最佳证据总结

doi:10.3761/j.issn.0254-1769.2022.14.015

摘要/Abstract

摘要：

目的检索、分析和汇总妊娠相关静脉血栓栓塞症（pregnancy associated venous thromboembolism,PA-VTE）评估与预防的最佳证据,为临床中完善对PA-VTE患者的管理提供参考。方法检索UpToDate、BMJ Best Practice、Embase、Springer Link等网站或数据库中关于PA-VTE评估与预防的所有证据,包括指南、系统评价、最佳临床实践信息册、证据总结、专家共识等。检索时限为2015年1月—2021年5月。由2名研究人员独立进行文献评价,4名研究人员进行证据提取、翻译及整合。结果共纳入11篇文献,其中指南4篇、临床决策1篇、专家共识3篇、系统评价3篇。从PA-VTE危险因素的评估、评估时机、评估工具、基础预防、物理预防、药物预防、健康宣教7个方面总结20条证据。结论该研究总结了PA-VTE评估与预防的最佳证据,建议制订符合本国国情的PA-VTE风险评估工具,筛查相关危险因素并分层管理,加强孕产妇PA-VTE健康教育,以达到降低发生率的目标。

关键词: 妊娠相关静脉血栓栓塞症, 评估, 预防, 循证护理学

Abstract:

Objective To retrieve,evaluate and summarize the best evidence for the evaluation and prevention of pregnancy associated venous thromboembolism（PA-VTE）,so as to provide references for clinical management. Methods We searched the literature from the clinical decision-making system UpToDate,BMJ Best Practice,Embase,Springer Link and other websites or databases to collect relevant guidelines,systematic reviews,best practice information sheets,evidence summaries and expert consensuses. The search period was from January 2015 to May 2021,and 2 researchers conducted independent literature evaluation,and 4 researchers conducted evidence extraction,translation,and integration. Results A total of 11 articles were included,including 4 guidelines,1 clinical decision,3 expert consensuses,and 3 systematic reviews. 20 pieces of evidence were summarized from 7 aspects of PA-VTE assessment of risk factors,assessment timing,assessment tools,basic prevention,drug prevention,and health education. Conclusion This study summarizes the best evidence for the evaluation and prevention of PA-VTE. It is recommended to develop maternal VTE risk assessment tools that meet the national conditions,screen VTE risk factors and manage them in layers,and strengthen maternal VTE health education to achieve the goal of reducing the incidence of PA-VTE.

Key words: Pregnancy Associated Venous Thromboembolism, Evaluation, Prevention, Evidence-Based Nursing

张焱, 张莉莉, 陈建红, 黄丽华, 宋运莲, 赖丽莉, 李晓芳, 葛诗琪, 倪玲. 妊娠相关静脉血栓栓塞症评估与预防的最佳证据总结[J]. 中华护理杂志, 2022, 57(14): 1765-1771.

ZHANG Yan, ZHANG Lili, CHEN Jianhong, HUANG Lihua, SONG Yunlian, LAI Lili, LI Xiaofang, GE Shiqi, NI Ling. Evidence summary for the evaluation and prevention of pregnancy associated venous thromboembolism[J]. Chinese Journal of Nursing, 2022, 57(14): 1765-1771.

图/表 3

表1 纳入文献的一般情况（n=11）

Table 1 Characteristics of included studies（n=11）

表2 指南的质量评价结果（n=4）

Table 2 Quality assessment of included guidelines（n=4）

表3 妊娠相关静脉血栓栓塞症评估与预防的最佳证据总结

Table 3 Evidence summary for the evaluation and prevention of pregnancy associated venous thromboembolism

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