妇科手术后发生静脉血栓风险评估工具研究进展.docVIP

妇科手术后发生静脉血栓风险评估工具研究进展 　　[摘要] 静脉血栓栓塞症是妇科手术后严重的并发症之一，显著影响了患者的术后转归和预后，尤其是近年来妇科恶性肿瘤根治术后静脉血栓的发生率呈上升趋势，引起了妇科学界的重视。相关的评估工具有助于早期预测妇科手术后静脉血栓发生的风险，提供针对不同病情的危险分层，为术后及时采取个体化预防措施提供理论指导。目前针对妇科手术后静脉血栓栓塞症可借鉴的评估工具主要包括，①国外评估工具：如Caprini评估量表、Autar评估量表和ACCP静脉血栓预防指南；②国内评估工具：如LDVT妇科临床评估量表和外科手术后LDVT风险评估表。 　　[关键词] 妇科手术；静脉血栓；风险；评估工具 　　[中图分类号] R713 [文献标识码] A [文章编号] 1673-7210（2016）11（c）-0060-04 　　Research progress of risk assessment tool for venous thrombosis after gynecological surgery 　　DAI Cheng WANG Donghong 　　Graduate school of Zunyi Medical College， Guizhou Province， Zunyi 563003， China 　　[Abstract] Venous thromboembolism is one of the most serious complications of gynecologic surgery， which significantly affects postoperative recovery and prognosis. Especially the recent years have witnessed the rising incidence of postoperative venous thrombosis after radical synergy of gynecological malignant neoplasms， which is attracting more and more attention in gynecology field. Relevant assessment tools can contribute to the early predictions of the occurrence of venous thrombosis after gynecologic surgeries， provide different risk stratification based on different conditions， thus theoretically guiding the timely individualized preventions after operation. Currently， the main assessment tools for postoperative venous thrombosis include， ①Foreign tools： Caprini assessment scale， Aura assessment scale and Guide for prevention of venous thrombosis ACCP； ②Domestic tools： LDVT scale and clinical evaluation of gynecological surgery and LDVT risk assessment table. 　　[Key words] Gynecologic surgery； Venous thrombosis； Risk； Assessment tool 　　?o脉血栓栓塞症（venous thromboembolism，VTE）包括深静脉血栓形成（deep vein thrombosis，DVT）和肺血栓栓塞症（pulmonary thromboembolism，PTE）。Nevelsteen[1]报道，未采取预防措施的妇科手术后VTE的发生率约为25%。VTE起病凶险且多预后不良，可使患者下肢发生完全或部分功能丧失而致残，甚至发生致命的肺栓塞或猝死[2]。早期评估及诊断VTE并采取相应的预防措施，是降低妇科术后VTE发生的关键！目前尚缺乏快速、较准确发现妇科手术后VTE的评估工具，这也是长期困扰妇科临床的难题之一。 　　1 国外VTE风险评估工具 　　1.1 Caprini评估量表 　　该量表由美国学者Caprini[3]于1986年提出，1991年