妊娠及产褥期静脉血栓栓塞症防治研究进展
Research Progress of Venous Thromboembolism in Pregnancy and Puerperal Period
DOI: 10.12677/acm.2024.143933, PDF,   
作者: 李文慧, 渠 苹:安徽中医药大学护理学院,安徽 合肥;银 萍:安徽省第二人民医院护理部,安徽 合肥
关键词: 妊娠期产褥期静脉血栓栓塞综述Gestational Postpartum Period Venous Thromboembolism Review
摘要: 妊娠期及产褥期孕产妇身体各项机能发生改变,发生VTE的危险因素较非孕期增加,静脉血栓栓塞症发病率较高。由于VTE起病隐匿,具有诊断准确率低,漏检率高,治疗困难,容易复发等问题。本文从妊娠及产褥期静脉血栓栓塞症的发病原因、影响因素、诊疗、评估等方面进行综述,尤其是针对临床静脉血栓栓塞症风险评估的叙述,以期达到静脉血栓栓塞症风险评估的规范化和科学化,从而降低其发病率和死亡率。
Abstract: During pregnancy and puerperal period, the body functions changed, the risk factors of VTE increased compared with non-pregnancy, and the incidence of venous thromboembolism was higher. Due to the hidden onset of VTE, the diagnosis accuracy is low, the rate of missing detection is high, the treatment is difficult, and the recurrence is easy. This paper reviews the causes, influencing factors, diagnosis, treatment and evaluation of venous thromboembolism in pregnancy and puerperal period, especially the description of clinical risk assessment of venous thromboembolism, in order to achieve the standardization and scientific risk assessment of venous thromboembolism, so as to reduce its morbidity and mortality.
文章引用:李文慧, 银萍, 渠苹. 妊娠及产褥期静脉血栓栓塞症防治研究进展[J]. 临床医学进展, 2024, 14(3): 1986-1992. https://doi.org/10.12677/acm.2024.143933

参考文献

[1] 李海燕, 张玲娟, 陆清声, 等. 静脉血栓栓塞症防治护理指南[M]. 北京: 人民卫生出版社, 2020: 1.
[2] 朱燕, 陈奕. 妊娠相关血栓栓塞性疾病的风险评估及预防研究现状[J]. 中华医学杂志, 2018, 98(23): 1893-1896.
[3] Alsheef, M.A., Alabbad, A.M., Albassam, R.A., et al. (2020) Pregnancy and Venous Thromboembolism: Risk Factors, Trends, Management, and Mortality. BioMed Research International, 2020, Article ID: 4071892. [Google Scholar] [CrossRef] [PubMed]
[4] Hwang, H.G., Lee, J.H. and Bang, S.M. (2023) Incidence of Pregnancy-Associated Venous Thromboembolism: Second Nationwide Study. Thrombosis and Haemostasis, 123, 904-910. [Google Scholar] [CrossRef] [PubMed]
[5] Cantrell, L.A., Garcia, C. and Maitland, H.S. (2018) Thrombosis and Thromboprophylaxis in Gynecology Surgery. Clinical Obstetrics and Gynecology, 61, 269-277. [Google Scholar] [CrossRef
[6] Brenner, B. (2004) Haemostatic Changes in Pregnancy. Thrombosis Research, 114, 409-414. [Google Scholar] [CrossRef] [PubMed]
[7] Simcox, L.E., Ormesher, L., Tower, C., et al. (2015) Pulmonary Thromboembolism in Pregnancy: Diagnosis and Management. Breathe (Sheff), 11, 282-289. [Google Scholar] [CrossRef] [PubMed]
[8] Middeldorp, S. amd Ankum, W.M. (2018) Venous Thromboembolism after Induced Abortion: The Shorter the Pregnancy, the Lower the Risk? The Lancet Haematology, 5, e271-e272. [Google Scholar] [CrossRef
[9] Abbattista, M., Gianniello, F., Novembrino, C., et al. (2020) Risk of Pregnancy-Related Venous Thromboembolism and Obstetrical Complications in Women with Inherited Type I Antithrombin Deficiency: A Retrospective, Single-Centre, Cohort Study. The Lancet Haematology, 7, e320-e328. [Google Scholar] [CrossRef
[10] 陈倩, 胡雅毅. 妊娠相关静脉血栓栓塞的危险因素及其预防决策[J]. 中华妇幼临床医学杂志(电子版), 2019, 15(6): 623-631.
[11] 段巍芳, 张卫社, 张洁洁, 等. 高龄孕妇年龄与围产期结局的关系探讨[J]. 现代妇产科进展, 2020, 29(6): 429-433.
[12] Malinowskia, K., Bomba-Opoñ, D., Parrish, J., et al. (2017) Venous Thromboembolism in Obese Pregnant Women: Approach to Diagnosis and Management. Ginekologia Polska, 88, 453-459. [Google Scholar] [CrossRef
[13] 韦海棠, 李静, 黄春力, 等. D-二聚体联合血栓风险评估表对产妇静脉血栓栓塞的诊断价值[J]. 中国医药, 2022, 17(3): 434-437.
[14] 龚文艳, 周璇, 侯黎莉. 足月妊娠产妇产后静脉血栓栓塞症快速评估简表的构建及预测效果检验[J]. 中华护理杂志, 2020, 55(7): 988-993.
[15] 黄晓惠. 妊娠晚期孕妇发生静脉血栓栓塞症的危险因素分析[J]. 中国医学工程, 2022, 30(3): 130-133.
[16] Bagot, C.N., Leishman, E., Onyiaodike, C.C., et al. (2019) Changes in Laboratory Markers of Thrombotic Risk Early in the First Trimester of Pregnancy May Be Linked to an Increase in Estradiol and Progesterone. Thrombosis Research, 178, 47-53. [Google Scholar] [CrossRef] [PubMed]
[17] 蔺莉, 王静. 重视高危因素, 规范管理、合理诊治妊娠期血栓栓塞性疾病——《2018ACOG实践简报: 妊娠期血栓栓塞症的临床管理指南》解读[J]. 中国全科医学, 2018, 21(30): 3659-3664.
[18] 广兰军. 剖宫产术后下肢深静脉血栓患者血流动力学及凝血指标分析[J]. 中国医学创新, 2022, 19(17): 58-61.
[19] 李霞林, 王永, 董旭东, 等. 妊娠期及产褥期孕产妇静脉血栓形成的危险因素及临床特征分析[J]. 中国实用妇科与产科杂志, 2023, 39(3): 331-335.
[20] Tadesse, T.A., Kedir, H.M., Fentie, A.M., et al. (2020) Venous Thromboembolism Risk and Thromboprophylaxis Assessment in Surgical Patients Based on Caprini Risk Assessment Model. Risk Management and Healthcare Policy, 13, 2545-2552. [Google Scholar] [CrossRef
[21] Autar, R. (1996) Nursing Assessment of Clients at Risk of Deep Vein Thrombosis (DVT): The Autar DVT Scale. Journal of Advanced Nursing, 23, 763-770. [Google Scholar] [CrossRef] [PubMed]
[22] 尹月娥, 周文娟, 方肖琼, 等. 产科静脉血栓风险评估表的信效度研究[J]. 护士进修杂志, 2017, 32(11): 970-973.
[23] 上海市母婴安全专家委员会, 上海市医学会围产医学专科分会, 上海市医学会妇产科专科分会产科学组, 等. 上海市产科静脉血栓栓塞症防治的专家共识[J]. 上海医学, 2020, 43(11): 645-650.
[24] Vander Pol, L.M., Tromeur, C., Bistervels, I.M., et al. (2019) Pregnancy-Adapted Years Algorithm for Diagnosis of Suspected Pulmonary Embolism. The New England Journal of Medicine, 380, 1139-1149. [Google Scholar] [CrossRef
[25] 周璇, 龚文艳. 基于Delphi-AHP法构建围生期静脉血栓栓塞症风险评估表[J]. 中华现代护理杂志, 2021, 27(22): 2964-2969.
[26] Zhang, M., Liu, M., Wang, D., et al. (2022) Development of a Risk Assessment Scale for Perinatal Venous Thromboembolism in Chinese Women Using a Delphi-AHP Approach. BMC Pregnancy Childbirth, 22, Article No. 426. [Google Scholar] [CrossRef] [PubMed]
[27] 苏俊, 张颖, 阮志强, 等. 妊娠及产褥期静脉血栓栓塞的诊疗进展[J]. 中国现代医生, 2022, 60(36): 128-132.
[28] 梁爽, 陈叙. 妊娠期及产褥期静脉血栓栓塞症非药物预防的方法及其评价[J]. 实用妇产科杂志, 2022, 38(5): 333-335.
[29] Bates, S.M., Rajasekhar, A., Middeldorp, S., et al. (2018) American Society of Hematology 2018 Guidelines for Management of Venous Thromboembolism: Venous Thromboembolism in the Context of Pregnancy. Blood Advances, 2, 3317-3359. [Google Scholar] [CrossRef] [PubMed]
[30] 中华医学会妇产科学分会产科学组. 妊娠期及产褥期静脉血栓栓塞症预防和诊治专家共识[J]. 中华妇产科杂志, 2021, 56(4): 236-243.
[31] Thomsen, A.J. and Greer, I.A. (2015) Thromboembolism Disease in Pregnancy and the Puerperium: Acute Management. Royal College of Obstetricians and Gynaecologists, 1-32.
[32] 马青变, 郑亚安, 朱继红, 等. 中国急性血栓性疾病抗栓治疗共识[J]. 中国急救医学, 2019, 39(6): 501-531.
[33] Pundir, J. and Coomarasamy, A. (2016) Prevention and Treatment of Thrombosis and Embolism during Pregnancy and the Puerperium. In: Obstetrics: Evidence-Based Algorithms, Cambridge University Press, Cambridge, 196-211. [Google Scholar] [CrossRef
[34] 李晓强, 张福先, 王深明. 深静脉血栓形成的诊断和治疗指南(第三版) [J]. 中国血管外科杂志(电子版), 2017, 9(4): 16-23.