摘要
目的比较昆士兰卫生组织(QLD)、中华医学会妇产科学分会产科学组(CMAOG)、英国皇家妇产科学院(RCOG)和Caprini评分量表对产褥期静脉血栓栓塞(VTE)风险的预测价值。方法采用回顾病例分析的方法,收集2015年1月至2021年12月潍坊市妇幼保健院(简称“我院”)收治的21例产褥期VTE患者的临床资料,评分量表采用QLD、CMAOG、RCOG及Caprini。以产前和产后24 h为时间节点,对患者风险因素评分和产前及产褥期预防性药物抗凝的理论与实际使用情况进行统计描述。结果在RCOG指南指导下,产褥期理论预防性药物抗凝率最高,覆盖率达100.00%。产褥期VTE患者中,RCOG评分ROC曲线下面积最大,其次为QLD和Caprini评分,CMAOG最小。结论在RCOG指南指导下产褥期药物预防抗凝覆盖面较广,能够覆盖更多VTE患者。四种血栓评估量表均能预测产褥期VTE的发生风险,RCOG评估量表对产褥期VTE发生风险预测价值更高。目前,我院存在VTE预防性药物抗凝使用不足的问题,医生应提高对VTE风险因素的认识和筛查,并加强对中、高风险VTE孕产妇的监护。
Objective To compare the predictive values of different puerperal venous thromboembolism(VTE)assessment scales recommended by guidelines of Queensland Health(QLD),Obstetrics Group,Branch of Obstetrics and Gynecology,Chinese Medical Association(CMAOG),Royal College of Obstetricians and Gynaecologists(RCOG)and Caprini scale.Methods Retrospective analysis of 21 cases of VTE from January 2015 to December 2021 in Weifang Maternal and Child Health Care Hospital(“our hospital”for short)was performed with risk assessment scales established according to guidelines of QLD,CMAOG,RCOG as well as Caprini scoring criteria,respectively.Statistic analysis was conducted on the theoretical and practical application of anticoagulant preventing VTE on the basis of thrombus risk factor scores both during prenatal period and at 24 hours after delivery.Results Under the RCOG guideline,the theoretical anticoagulation rate was 100.00%in puerperium,which could cover more VTE patients.In puerperium venous thrombosis,the area under ROC curve of RCOG score was the largest,followed by QLD score and Caprini score,the CMAOG score was the smallest.Conclusion The coverage of RCOG guidelines is wide,which can cover more VTE patients,however,the pharmaceutical prophylaxis of thromboemboism is still insufficient.Although all the four thrombus evaluation scales can predict the risk of puerperal VTE,the RCOG score shows better prediction of the VTE risk in the puerperium.At present,the application of anticoagulant preventing VTE is insufficient in our hospital.It is critical for clinicians to improve the understanding and screening of VTE risk factors,thereby favors the monitoring of pregnant women with medium and high risk of VTE.
作者
冯占芹
惠培业
孙广宁
曹建英
张安超
宋晓莹
张君
FENG Zhanqin;HUI Peiye;SUN Guangning;CAO Jianying;ZHANG Anchao;SONG Xiaoying;ZHANG Jun(Department of Pharmacy,Weifang Maternal and Child Health Care Hospital,Shangdong Province,Weifang 261000,China;Department of Medicine,Weifang Maternal and Child Health Care Hospital,Shangdong Province,Weifang 261000,China;Department of Obstetrics,Weifang Maternal and Child Health Care Hospital,Shangdong Province,Weifang 261000,China)
出处
《妇儿健康导刊》
2022年第11期90-93,F0004,共5页
JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE
基金
山东省潍坊市卫生健康委员会科研项目(WFWSJK-2021-198)。
关键词
产褥期
静脉血栓
抗凝
血栓评估量表
Puerperium
Venous thromboembolism
Anticoagulation
Thrombus assessment scale