孕产妇孕产期静脉血栓栓塞风险评估的最佳证据总结

Best Evidence Summary of Risk Assessment of Venous Thromboembolism during Pregnancy and Puerperium

目的获取国内外孕产妇孕产期相关静脉血栓风险评估的最佳证据,为构建评估工具提供参考依据。方法应用循证医学的方法,通过计算机检索Up To Data、BMJ、Cochrane Library、JBI、GIN、NCG、NICE、CMA、RNAO、PubMed、Embase、中国知网、万方数据库、中国生物医学数据库,选取符合纳入标准的相关文献,并通过2名研究员对文献进行独立的质量评价、证据提取及总结。结果共纳入文献12篇,其中包括临床实践指南6篇,高级临床决策1篇,系统评价5篇。从12篇文献中提取26条证据,最终整合形成4个维度,分别为既往因素(9条)、妊娠因素(4条)、产后因素(7条)和临时因素(6条)。结论基于循证证据总结孕产妇孕产期静脉血栓栓塞风险最佳证据,实现对孕产妇孕产期静脉血栓栓塞发生风险的动态评估,通过风险分层达到个体化风险管理的目的。

Objective To search the best evidence of risk assessment of venous thrombosis during pregnancy and puerperium at home and abroad,and to provide reference for the construction of assessment tool.Methods We searched databases including Up to Data,BMJ,Cochrane Library,JBI,GIN,NCG,NICE,CMA,RNAO,PubMed,Embase,CNKI,Wanfang database and China biomedical database by computer for literature meeting the inclusion criteria.Two researchers conducted independent quality evaluation,evidence extraction and summary of the literature.Results Twelve articles were enrolled,including 6 clinical practice guidelines,1 advanced clinical decision and 5 systematic reviews.A total of 26 pieces of best evidence were integrated into 4 domains:previous factors(9 pieces of evidence),pregnancy-related factors(4 pieces of evidence)postpartum factors(7 pieces of evidence)and temporary factors(6 pieces of evidence).Conclusion The individualized risk assessment of venous thromboembolism in pregnant and puerperal women plays an important role in the prevention of pregnant and puerperal related thrombosis and provides evidence-based basis for clinical workers.