妊娠相关静脉血栓栓塞症的预防和治疗

妊娠相关静脉血栓栓塞症(pregnancy associated venous thromboembolism,PA-VTE)系指妊娠期及产褥期发生的静脉血栓栓塞症(venous thromboembolism,VTE)。PA-VTE可以发生在妊娠的不同时期,产褥期风险最高,发生率为产前的2~5倍,尤以产后6周内风险最高。PA-VTE危害极大,目前已成为发达国家孕产妇死亡的重要原因之一。PA-VTE的提出,意在强调其预防和诊治应基于妊娠这一特殊阶段的病理生理学特征,制定专科管理规范。而目前一些国家已有针对PA-VTE的防治指南和共识,但中国仅在少数VTE管理指南中提及对该类疾病的防治,具体防治方案仍不明确,临床中迫切需要制定适合我国妊娠患者VTE预防和治疗的指南,以规范临床实践。本文综述PA-VTE病理生理学特征、临床筛查、预防、治疗和我国临床实践现状。

Prevention and Treatment of Pregnancy Associated Venous Thromboembolism

Pregnancy associated venous thromboembolism(PA-VTE)refers to venous thromboembolism in pregnancy and puerperium.PA-VTE can occur at different stages of pregnancy,with the highest risk in puerperium,2-5 times more likely to occur than pregnancy states,especially in 6 weeks after delivery.PA-VTE is extremely harmful and has become one of the important causes of maternal death in developed countries.The proposal of PA-VTE is intended to emphasize that its prevention,diagnosis and treatment should be based on the pathophysiological characteristics of the special stage of pregnancy.At present,some countries have reached a consensus on the prevention and treatment of PA-VTE,but only a few VTE management guidelines in China mention the prevention and treatment of this kind of disease,and the specific prevention and treatment plan is still unclear.In clinical practice,it is urgent to develop guidelines suitable for the prevention and treatment of patients in China,so as to regulate the clinical practice in China.This article is a systematic review of the pathophysiological characteristics,clinical screening,prevention and treatment of PA-VTE and the current situation of clinical practice in China.