中国围产期妇女发生静脉血栓栓塞症危险因素的Meta分析

Risk factors for Venous Thromboembolism in Perinatal Women of China:A Meta-analysis

目的:评价中国围产期妇女发生静脉血栓栓塞症的危险因素。方法:检索中国知网、万方等中文数据库以及Pubmed、EMBASE等英文数据库收录的关于中国围产期妇女发生静脉血栓栓塞症危险因素的病例对照研究,采用RevMan 5.4软件进行Meta分析。结果:共纳入16篇文献,包含围产期静脉血栓栓塞症1094例。中国围产期妇女发生静脉血栓栓塞症的危险因素、OR值及95%可信区间(CI)分别为体质量指数1.62(1.34,1.97)、D二聚体1.75(1.42,2.17)、年龄2.06(1.68,2.53)、多胎妊娠5.78(4.28,7.82)、剖宫产3.46(2.16,5.54)、合并高血压2.59(1.73,3.87)、合并高血脂2.83(2.08,3.86)、合并糖尿病2.31(1.81,2.94)、血栓史2.89(2.06,4.07)、高凝状态2.15(1.51,3.07)、产后出血2.41(1.71,3.40)、卧床时间≥72h 2.03(1.64,2.52)、子痫前期3.63(2.33,5.64)、RCOG评分2.16(1.36,3.42)。结论:体质量指数、D二聚体、年龄、多胎妊娠、剖宫产、合并高血压、合并高血脂、合并糖尿病、血栓史、高凝状态、产后出血、卧床时间≥72h、子痫前期、RCOG评分是中国围产期妇女发生静脉血栓栓塞症的危险因素,临床工作者应针对上述危险因素制定预防管理措施,以降低围产期妇女静脉血栓栓塞症的发生概率。

Objective:To systematically evaluate the risk factors for venous thromboembolism in perinatal w omen of China.Methods:CNKI,WanFang and other Chinese database and Pub M ed,Embase and other English database w ere searched to collect the case control studies about the risk factors for venous thromboembolism in perinatal w omen of China.M eta-analysis w as performed by using RevM an 5.4 softw are.Results:A total of 16 articles involving 1094 patients w ere collected.The meta-analysis results show ed that body mass index1.62(1.34,1.97),D-dimer1.75(1.42,2.17),age2.06(1.68,2.53),multiple pregnancy5.78(4.28,7.82),cesarean section3.46(2.16,5.54),combined hypertension2.59(1.73,3.87),combined hyperlipidemia2.83(2.08,3.86),combined diabetes mellitus2.31(1.81,2.94),history of thrombosis2.89(2.06,4.07),hypercoagulable state2.15(1.51,3.07),postpartum hemorrhage2.41(1.71,3.40),bed rest time≥72 h 2.03(1.64,2.52),preeclampsia 3.63(2.33,5.64),RCOG score2.16(1.36,3.42)w ere the risk factors for venous thromboembolism in perinatal w omen of China.Conclusion:Body mass index,age,multiple pregnancy,cesarean section,combined hypertension,combined hyperlipidemia,combined diabetes mellitus,history of thrombosis,hypercoagulable state,postpartum hemorrhage,bed rest time≥72 h,preeclampsia,RCOG score w ere the risk factors for venous thromboembolism in perinatal w omen of China.The clinicians should formulate relevant preventive management measures according to the above risk factors,in order to reduce the incidence rate of venous thromboembolism in perinatal w omen.