妊娠相关静脉血栓药物预防的最佳证据总结

Summary of best available evidence on pharmacological prophylaxis for pregnancy-associated venous thromboembolism

  • 摘要:
    目的 检索、分析和汇总妊娠相关静脉血栓(PA-VTE)药物预防的最佳证据。
    方法 应用循证医学方法,通过计算机检索关于PA-VTE药物预防的所有证据,包括指南、专家共识、系统评价、临床决策、证据总结、推荐实践,时间范围限定为建库至2024年12月13日。2名研究者分别独立进行文献质量评价,当意见出现分歧时,加入第3名研究者共同讨论,并形成一致的最终评价。
    结果 共纳入20篇文献,含6篇指南、7篇系统评价、2篇临床决策、3篇专家共识、2篇证据总结。从药物种类、药物选择、药物禁忌证、预防用药时机、预防策略及实施方案、用药注意事项和健康教育7个方面,总结28条证据。
    结论 本研究汇总了PA-VTE药物预防的最佳证据,可指导医务人员为孕产妇提供个体化的药物预防策略,以降低静脉血栓发生率及改善妊娠结局。

     

    Abstract:
    Objective To search, analyze, and summarize the best available evidence on pharmacological prophylaxis for pregnancy-associated venous thromboembolism (PA-VTE).
    Methods Utilizing evidence-based medicine methodologies, a computerized search was conducted for all evidence pertaining to pharmacological prophylaxis of PA-VTE, including guidelines, expert consensus, systematic reviews, clinical decisions, evidence summaries, and recommended practices. The time for the search ranged from the establishment of relevant databases up to December 13, 2024. Two researchers independently assessed the quality of the included literature. In cases of disagreement, a third researcher was consulted to reach a consensus on the final evaluation.
    Results A total of 20 articles were included, comprising 6 guidelines, 7 systematic reviews, 2 clinical decisions, 3 expert consensus documents, and 2 evidence summaries. From seven aspects including drug types, drug selection, drug contraindications, timing of prophylactic medication, prophylactic strategies and implementation plans, medication precautions, and health education, 28 pieces of evidence were summarized.
    Conclusion This study has compiled the best available evidence on pharmacological prophylaxis for PA-VTE, which can guide healthcare professionals inproviding individualized pharmacological prophylaxis strategies for pregnant women, thereby reducing the incidence of venous thromboembolism and improving pregnancy outcomes.

     

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