\u9759\u8109\u8840\u6813\u6813\u585e (VTE) \u6307\u5728\u9759\u8109\u4e2d\u5f62\u6210\u7684\u8840\u51dd\u5757 [1]\u3002VTE \u7684\u4e24\u4e2a\u6700\u5e38\u89c1\u8868\u73b0\u662f\u6df1\u9759\u8109\u8840\u6813 (DVT) \u548c\u80ba\u6813\u585e (PE) [1]\u3002DVT \u662f\u6307\u6df1\u9759\u8109\u5185\u5f62\u6210\u8840\u6813\uff1b\u5f53\u8840\u6813\u8131\u843d\uff0c\u7ecf\u8840\u6d41\u8fdb\u5165\u80ba\u90e8\u5e76\u963b\u585e\u80ba\u8840\u7ba1\u65f6\uff0c\u5c31\u4f1a\u53d1\u751f PE [1]\u3002<\/p>\n
VTE \u5728\u7537\u6027\u548c\u5973\u6027\u4e2d\u5747\u53ef\u53d1\u751f\uff0c\u5e76\u4e14\u53ef\u80fd\u5728\u5176\u4e00\u751f\u7684\u4e0d\u540c\u9636\u6bb5\u51fa\u73b0 [2]\u3002\u4f46\u662f\uff0c\u5973\u6027\uff08\u5c24\u5176\u662f\u80b2\u9f84\u671f\u5973\u6027\uff09\u7f79\u60a3 VTE \u7684\u9884\u8ba1\u7ec8\u751f\u98ce\u9669\u9ad8\u4e8e\u7537\u6027 [2]\u3002<\/p>\n
\u636e\u4f30\u8ba1\uff0c\u5168\u7403\u666e\u901a\u4eba\u7fa4\u4e2d VTE \u7684\u5e74\u53d1\u75c5\u7387\u7ea6\u4e3a\u6bcf 1000 \u4eba\u4e2d 1\u20132 \u4f8b\uff0c\u6298\u5408\u6bcf\u5e74\u7ea6 300 \u4e07\u81f3 1000 \u4e07\u4f8b VTE [4]\u3002\u7136\u800c\uff0c\u7528\u4e8e\u660e\u786e\u786e\u5b9a\u00a0VTE \u53d1\u75c5\u7387\u7684\u6570\u636e\u4ecd\u7136\u5f88\u5c11\uff0c\u5728\u5973\u6027\u4e2d\u5c24\u4e3a\u5982\u6b64\u3002<\/p>\n
\u76f4\u5230\u6700\u8fd1\uff0c\u4e9a\u6d32\u4eba\u53e3\u4e2d VTE \u7684\u53d1\u751f\u7387\u88ab\u8ba4\u4e3a\u4f4e\u4e8e\u767d\u79cd\u4eba\u3002\u7136\u800c\uff0c\u7814\u7a76\u8868\u660e\uff0c\u8fd9\u53ef\u80fd\u662f\u7531\u4e8e\u8bca\u65ad\u4e0d\u8db3\u548c\u62a5\u544a\u4e0d\u8db3\uff0c\u4ece\u800c\u5bfc\u81f4\u4e9a\u6d32\u4f4e\u4f30\u4e86 VTE \u7684\u53d1\u751f\u7387[5,6]\u3002\u968f\u7740\u4eba\u4eec\u5bf9 VTE \u5728\u4e9a\u6d32\u4eba\u7fa4\u4e2d\u91cd\u8981\u6027\u7684\u8ba4\u8bc6\u4e0d\u65ad\u63d0\u9ad8\uff0c\u4ee5\u53ca\u8bca\u65ad\u6c34\u5e73\u7684\u6539\u5584\uff0c\u62a5\u544a\u7684 VTE \u75c5\u4f8b\u6570\u4f3c\u4e4e\u6709\u6240\u589e\u52a0 [5]\u3002<\/p>\n
\u5973\u6027\u53d1\u751f VTE \u7684\u5371\u9669\u56e0\u7d20\u4e0e\u4e00\u822c\u4eba\u7fa4\u76f8\u4f3c\uff0c\u53ea\u662f\u6b64\u7c7b\u5371\u9669\u56e0\u7d20\u5728\u5176\u751f\u80b2\u5e74\u9f84\u671f\u95f4\u4f1a\u8fdb\u4e00\u6b65\u589e\u52a0 [1,2]\u3002<\/p>\n
\u5e94\u7528\u4e8e\u5973\u6027\u7684\u6fc0\u7d20\u6cbb\u7597\uff0c\u5c24\u5176\u662f\u8054\u5408\u53e3\u670d\u907f\u5b55\u836f (COC) \u548c\u6fc0\u7d20\u66ff\u4ee3\u7597\u6cd5\u00a0(HRT)\uff0c\u5df2\u88ab\u8bc1\u5b9e\u4f1a\u5f71\u54cd\u51dd\u8840\u529f\u80fd\uff0c\u4e0e\u672a\u4f7f\u7528\u8005\u76f8\u6bd4\uff0c\u53ef\u4f7f VTE \u98ce\u9669\u589e\u52a0 2\u20134 \u500d\u3002\u5b83\u4eec\u5df2\u88ab\u8bc1\u660e\u53ef\u8bf1\u5bfc\u5bf9\u6d3b\u5316\u86cb\u767d C \u7684\u83b7\u5f97\u6027\u6297\u6027\uff0c\u800c\u6d3b\u5316\u86cb\u767d C \u662f\u4ea7\u751f\u5929\u7136\u6297\u51dd\u7269\u8d28\u86cb\u767d S \u7684\u5fc5\u9700\u7269\u8d28\u3002\u6b64\u5916\uff0cCOC \u548c HRT \u4e2d\u7684\u6fc0\u7d20\u7ec4\u5408\u4f1a\u5347\u9ad8\u67d0\u4e9b\u51dd\u8840\u56e0\u5b50\uff08\u51dd\u8840\u9176\u539f\u3001\u51dd\u8840\u56e0\u5b50 VII\u3001VIII \u548c X\uff09\u7684\u6c34\u5e73\uff0c\u5e76\u964d\u4f4e\u5176\u4ed6\u5929\u7136\u6297\u51dd\u7269\u8d28\uff08\u5982\u6297\u51dd\u8840\u9176\uff09\u7684\u6c34\u5e73 [8,9]\u3002<\/p>\n
\u6fc0\u7d20\u7597\u6cd5\u8fd8\u4e0e\u52a0\u91cd\u9057\u4f20\u6027\u8840\u6813\u503e\u5411\uff08\u4e00\u79cd\u589e\u52a0\u8840\u6db2\u9ad8\u51dd\u6027\u7684\u9057\u4f20\u6027\u75be\u75c5\uff09\u7684\u5f71\u54cd\u76f8\u5173 [9,11]\u3002\u5e38\u89c1\u7684\u8840\u6813\u503e\u5411\u7c7b\u578b\u5305\u62ec\uff1a\u56e0\u5b50\u00a0V Leiden\u3001\u86cb\u767d C \u7f3a\u4e4f\u75c7\u3001\u86cb\u767d S \u7f3a\u4e4f\u75c7\u548c\u6297\u51dd\u8840\u9176\u7f3a\u4e4f\u75c7 [11]\u3002<\/p>\n
\u6b63\u5728\u63a5\u53d7\u6fc0\u7d20\u6cbb\u7597\u7684\u5973\u6027\u6216\u598a\u5a20\u5973\u6027\u53d1\u751f VTE \u7684\u98ce\u9669\u5982\u4e0b\u8868\u6240\u793a\u3002\u7531\u4e8e\u9057\u4f20\u6027\u8840\u6813\u503e\u5411\u8f83\u4e3a\u5c11\u89c1\uff0c\u56e0\u6b64\u4e0d\u5efa\u8bae\u8fdb\u884c\u5e38\u89c4\u7b5b\u67e5\u3002\u7136\u800c\uff0c\u5bf9\u4e8e\u4e25\u91cd\u9057\u4f20\u6027\u8840\u6813\u503e\u5411\uff08\u5982\u56e0\u5b50 V\u00a0Leiden\uff09\u643a\u5e26\u8005\u7684\u65e0\u75c7\u72b6\u4eb2\u5c5e\uff0c\u5219\u5efa\u8bae\u8fdb\u884c\u68c0\u6d4b [12]\u3002<\/p>\n
\n
70\u201380% \u7684 VTE \u53d1\u4f5c\u5728\u598a\u5a20\u671f\u4e3a\u4e0b\u80a2 DVT\uff0c43\u201360% \u7684 PE \u53d1\u751f\u5728\u4ea7\u540e\u6700\u521d 6 \u5468\u5185 [8]\u3002<\/p>\n
\u589e\u52a0\u5973\u6027\u00a0VTE \u98ce\u9669\u7684\u5176\u4ed6\u56e0\u7d20\u8fd8\u5305\u62ec\uff1a\u5927\u624b\u672f\u540e\u6062\u590d\u671f\u6d3b\u52a8\u4e0d\u8db3\uff1b\u4e25\u91cd\u4e14\u672a\u7ecf\u6cbb\u7597\u7684\u9759\u8109\u66f2\u5f20\uff1b\u764c\u75c7\u53ca\u5176\u6cbb\u7597\uff1b\u5fc3\u810f\u75c5\u548c\u4e2d\u98ce\uff1bVTE \u5bb6\u65cf\u53f2\uff1b\u80a5\u80d6\uff1b\u5438\u70df\u53ca\u996e\u9152\u3002<\/p>\n
\u666e\u53ca\u4f4e\u98ce\u9669 COC \u7684\u4ee5\u53ca\u51cf\u5c11 HRT \u5904\u65b9\uff0c\u5728\u4e00\u5b9a\u7a0b\u5ea6\u4e0a\u6709\u52a9\u4e8e\u964d\u4f4e VTE \u9ad8\u5371\u5973\u6027\u7684\u53d1\u75c5\u98ce\u9669\u3002\u7136\u800c\uff0c\u7531\u4e8e\u5176\u4ed6\u98ce\u9669\u56e0\u7d20\u4e0e\u598a\u5a20\u56fa\u6709\u98ce\u9669\u4e4b\u95f4\u5b58\u5728\u6f5c\u5728\u7684\u590d\u6742\u76f8\u4e92\u4f5c\u7528\uff0c\u56e0\u6b64\u6709\u5fc5\u8981\u4e3a\u4e9a\u592a\u5730\u533a\u5236\u5b9a\u5168\u9762\u4e14\u672c\u571f\u5316\u7684\u6307\u5357\u3002<\/p>\n
\u4f8b\u5982\uff0c\u65b0\u52a0\u5761\u7684\u6307\u5357\u5728\u82f1\u56fd\u7687\u5bb6\u5987\u4ea7\u79d1\u533b\u5e08\u5b66\u4f1a\u6307\u5357\u7684\u57fa\u7840\u4e0a\u4f5c\u51fa\u8c03\u6574\uff0c\u4ee5\u53cd\u6620\u4e9a\u6d32\u4eba\u7fa4\u4e2d\u66f4\u9ad8\u6bd4\u4f8b\u7684\u9ad8\u5371\u8840\u6813\u503e\u5411\uff1b\u540c\u65f6\uff0c\u5c06\u5e74\u9f84 > 35 \u5c81\u7eb3\u5165\u4ea7\u540e VTE \u7684\u5371\u9669\u56e0\u7d20\u4e4b\u4e00\uff0c\u589e\u52a0\u4e86\u5bf9 VTE \u9ad8\u5371\u60a3\u8005\u786c\u819c\u5916\u9ebb\u9189\/\u7ed9\u836f\u7684\u76f8\u5173\u6307\u5bfc\uff0c\u5e76\u5bf9\u6cbb\u7597\u65b9\u6848\u4f5c\u51fa\u4fee\u8ba2\uff0c\u4ee5\u66f4\u597d\u5730\u9002\u5e94\u5f53\u5730\u4eba\u7fa4\u3002<\/p>\n
VTE (DVT<\/a>) \u4e3b\u8981\u901a\u8fc7\u75c5\u53f2\u548c\u4f53\u683c\u68c0\u67e5\u8bca\u65ad\uff0c\u4f46\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u4e5f\u8d77\u4e00\u5b9a\u4f5c\u7528\u3002\u4e3b\u8981\u8bca\u65ad\u65b9\u5f0f\u5982\u4e0b\uff1a<\/p>\n \u6709\u591a\u79cd\u95ee\u5377\u5f62\u5f0f\u7684\u5de5\u5177\uff0c\u53ef\u7528\u4e8e\u8bc4\u4f30\u5973\u6027\u53d1\u751f VTE \u7684\u98ce\u9669\u3002\u8fd9\u4e9b\u8bc4\u4f30\u5de5\u5177\u6240\u6db5\u76d6\u7684\u95ee\u9898\u5305\u62ec\uff1a<\/p>\n \u975e\u598a\u5a20\u5973\u6027\u7684 VTE \u9884\u9632\uff08\u8840\u6813\u9884\u9632\uff09\u4e0e\u7537\u6027\u60a3\u8005\u7684\u6cbb\u7597\u65b9\u6848\u7c7b\u4f3c\u3002\u6839\u636e\u51fa\u8840\u98ce\u9669\uff0c\u5bf9\u63a5\u53d7\u9ad8\u5371\u624b\u672f\u7684\u60a3\u8005\u7ed9\u4e88\u6297\u51dd\u9884\u9632\u6cbb\u7597 [6]\u3002<\/p>\n \u5bf9\u4e8e\u5b55\u5987\uff0c\u9884\u9632\u7684\u9996\u9009\u6297\u51dd\u5242\u662f LMWH\u3002\u9884\u9632\u6cbb\u7597\u7684\u65f6\u673a\u5c06\u53d6\u51b3\u4e8e\u98ce\u9669\u8bc4\u4f30\u8bc4\u5206\u3002\u9ad8\u5371\u4eba\u7fa4\u5728\u786e\u8ba4\u598a\u5a20\u540e\u5373\u5f00\u59cb\u6297\u51dd\u9884\u9632\u6cbb\u7597\uff0c\u800c\u4f4e\u5371\u4eba\u7fa4\u5219\u4ece\u598a\u5a20 28 \u5468\uff08\u598a\u5a20\u7b2c\u4e09\u5b55\u671f\/\u5b55\u665a\u671f\uff09\u5f00\u59cb [13]\u3002\u598a\u5a20\u671f\u9700\u8981\u8fdb\u884c\u9884\u9632\u6cbb\u7597\u7684\u5987\u5973\uff0c\u5728\u5206\u5a29\u540e\u8fd8\u9700\u7ee7\u7eed\u6297\u51dd\u9884\u9632\u6cbb\u7597\uff0c\u81f3\u5c11 6 \u5468\u3002<\/p>\n \u9664\u598a\u5a20\u671f\u5916\uff0c\u5973\u6027 VTE \u7684\u6cbb\u7597\u4e0e\u7537\u6027\u76f8\u4f3c\u3002\u4e3b\u8981\u6cbb\u7597\u65b9\u5f0f\u662f\u4f7f\u7528\u6297\u51dd\u5242\uff0c\u4f8b\u5982\u809d\u7d20\u3001\u4f4e\u5206\u5b50\u91cf\u809d\u7d20 (LMWH)\u3001\u7ef4\u751f\u7d20 K \u62ee\u6297\u5242\u548c\u76f4\u63a5\u53e3\u670d\u6297\u51dd\u5242 (DOAC)\u3002\u5176\u4e2d\uff0cLMWH \u548c DOAC \u7684\u51fa\u8840\u98ce\u9669\u8f83\u4f4e\u3002<\/p>\n \u5bf9\u4e8e\u598a\u5a20\u671f\u7684 VTE\uff0cLMWH \u662f\u9996\u9009\u6297\u51dd\u5242\u3002\u6297\u51dd\u836f\u7269\u4ee5\u6cbb\u7597\u5242\u91cf\u5728\u6574\u4e2a\u598a\u5a20\u671f\u53ca\u4ea7\u540e 6 \u5468\u5185\u6301\u7eed\u5e94\u7528\uff0c\u81f3\u5c11\u6301\u7eed 3 \u4e2a\u6708\u3002\u5728\u6cbb\u7597\u671f\u95f4\uff0c\u5e94\u5728\u51cf\u5c11\u5242\u91cf\u6216\u505c\u6b62\u6cbb\u7597\u524d\u91cd\u590d VTE \u98ce\u9669\u8bc4\u5206 [13]\u3002<\/p>\n \n \u53c2\u8003\u6587\u732e\uff1a\u00a0<\/em><\/p>\n [1]<\/a> National Heart, Lung, and Blood Institute.What is venous thromboembolism.Available at: https:\/\/www.nhlbi.nih.gov\/health\/venous-thromboembolism.Accessed October 2022. \u9759\u8109\u8840\u6813\u6813\u585e (VTE) \u6307\u5728\u9759\u8109\u4e2d\u5f62\u6210\u7684\u8840\u51dd\u5757 [1]\u3002VTE \u7684\u4e24\u4e2a\u6700\u5e38\u89c1\u8868\u73b0\u662f\u6df1\u9759\u8109\u8840\u6813 (DVT) \u548c\u80ba\u6813\u585e (PE) [1]\u3002DVT \u662f\u6307\u6df1\u9759\u8109\u5185\u5f62\u6210\u8840\u6813\uff1b\u5f53\u8840\u6813\u8131\u843d\uff0c\u7ecf\u8840\u6d41\u8fdb\u5165\u80ba\u90e8\u5e76\u963b\u585e\u80ba\u8840\u7ba1\u65f6\uff0c\u5c31\u4f1a\u53d1\u751f PE [1]\u3002 VTE \u5728\u7537\u6027\u548c\u5973\u6027\u4e2d\u5747\u53ef\u53d1\u751f\uff0c\u5e76\u4e14\u53ef\u80fd\u5728\u5176\u4e00\u751f\u7684\u4e0d\u540c\u9636\u6bb5\u51fa\u73b0 [2]\u3002\u4f46\u662f\uff0c\u5973\u6027\uff08\u5c24\u5176\u662f\u80b2\u9f84\u671f\u5973\u6027\uff09\u7f79\u60a3 VTE \u7684\u9884\u8ba1\u7ec8\u751f\u98ce\u9669\u9ad8\u4e8e\u7537\u6027 [2]\u3002 VTE \u7684\u53d1\u751f\u7387 \u636e\u4f30\u8ba1\uff0c\u5168\u7403\u666e\u901a\u4eba\u7fa4\u4e2d VTE \u7684\u5e74\u53d1\u75c5\u7387\u7ea6\u4e3a\u6bcf 1000 \u4eba\u4e2d 1\u20132 \u4f8b\uff0c\u6298\u5408\u6bcf\u5e74\u7ea6 300 \u4e07\u81f3 1000 \u4e07\u4f8b VTE [4]\u3002\u7136\u800c\uff0c\u7528\u4e8e\u660e\u786e\u786e\u5b9a\u00a0VTE \u53d1\u75c5\u7387\u7684\u6570\u636e\u4ecd\u7136\u5f88\u5c11\uff0c\u5728\u5973\u6027\u4e2d\u5c24\u4e3a\u5982\u6b64\u3002 \u76f4\u5230\u6700\u8fd1\uff0c\u4e9a\u6d32\u4eba\u53e3\u4e2d VTE \u7684\u53d1\u751f\u7387\u88ab\u8ba4\u4e3a\u4f4e\u4e8e\u767d\u79cd\u4eba\u3002\u7136\u800c\uff0c\u7814\u7a76\u8868\u660e\uff0c\u8fd9\u53ef\u80fd\u662f\u7531\u4e8e\u8bca\u65ad\u4e0d\u8db3\u548c\u62a5\u544a\u4e0d\u8db3\uff0c\u4ece\u800c\u5bfc\u81f4\u4e9a\u6d32\u4f4e\u4f30\u4e86 VTE \u7684\u53d1\u751f\u7387[5,6]\u3002\u968f\u7740\u4eba\u4eec\u5bf9 VTE \u5728\u4e9a\u6d32\u4eba\u7fa4\u4e2d\u91cd\u8981\u6027\u7684\u8ba4\u8bc6\u4e0d\u65ad\u63d0\u9ad8\uff0c\u4ee5\u53ca\u8bca\u65ad\u6c34\u5e73\u7684\u6539\u5584\uff0c\u62a5\u544a\u7684 VTE \u75c5\u4f8b\u6570\u4f3c\u4e4e\u6709\u6240\u589e\u52a0 [5]\u3002 \u5973\u6027\u53d1\u751f VTE \u7684\u5371\u9669\u56e0\u7d20 \u5973\u6027\u53d1\u751f VTE 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\u5973\u6027 VTE \u98ce\u9669\u8bc4\u4f30\u5de5\u5177<\/h2>\n
\u5973\u6027 VTE \u7684\u9884\u9632<\/h2>\n
\u5973\u6027 VTE \u7684\u6cbb\u7597<\/h2>\n
\n[2]<\/a> Arnesen CAL, Veres K, Horv\u00e1th-Puh\u00f3 E, Hansen JB, S\u00f8rensen HT, Br\u00e6kkan SK.Estimated lifetime risk of venous thromboembolism in men and women in a Danish nationwide cohort: impact of competing risk of death.Eur J Epidemiol.Feb 2022;37(2):195-203. doi:10.1007\/s10654-021-00813-w.
\n[3] <\/a>Scheres LJJ, Lijfering WM, Cannegieter SC.Current and future burden of venous thrombosis: Not simply predictable.Res Pract Thromb Haemost.Apr 2018;2(2):199-208. doi:10.1002\/rth2.12101.
\n[4]World Thrombosis Day.Open your eyes to venous thromboembolism (VTE).Available at: https:\/\/www.worldthrombosisday.org\/issue\/vte\/#:~:text=Every%20year%2C%20there %20are%20approximately%2010%20million%20cases%20of%20VTE%20worldwide.Accessed October 2022.
\n[5]<\/a> Lee LH, Gallus A, Jindal R, Wang C, Wu CC.Incidence of Venous Thromboembolism in Asian Populations: A Systematic Review.Thromb Haemost.Dec 2017;117(12):2243-2260. doi:10.1160\/th17-02-0134.
\n[6]<\/a> Wang KL, Yap ES, Goto S, Zhang S, Siu CW, Chiang CE.The diagnosis and treatment of venous thromboembolism in asian patients.Thromb J.2018;16:4.doi:10.1186\/s12959-017-0155-z.
\n[7]<\/a> National Blood Clot Alliance.Women and blood clots risk timeline.Available at: https:\/\/www.stoptheclot.org\/news\/may-is-womens-health-month\/.Accessed October 2022.
\n[8]<\/a> de Oliveira A, Pasch\u00f4a AF, Marques MA. Venous thromboembolism in women: new challenges for an old disease.J Vasc Bras.Jul 6 2020;19:e20190148. doi:10.1590\/1677-5449.190148.
\n[9]<\/a> Jacobsen AF, Sandset PM.Venous thromboembolism associated with pregnancy and hormonal therapy.Best Pract Res Clin Haematol.Sep 2012;25(3):319-32. doi:10.1016\/j.beha.2012.07.006.
\n[10]<\/a> Sennstr\u00f6m M, Rova K, Hellgren M, et al. Thromboembolism and in vitro fertilization – a systematic review.Acta Obstet Gynecol Scand.Sep 2017;96(9):1045-1052. doi:10.1111\/aogs.13147.
\n[11]<\/a> National Health Services (United Kingdom).Thrombophilia.Available at: https:\/\/www.nhs.uk\/conditions\/thrombophilia\/.Accessed October 2022.
\n[12]<\/a> Gialeraki A, Valsami S, Pittaras T, Panayiotakopoulos G, Politou M.Oral Contraceptives and HRT Risk of Thrombosis.Clin Appl Thromb Hemost.Mar 2018;24(2):217-225. doi:10.1177\/1076029616683802.
\n[13]<\/a> Academy of Medicine Singapore, College of Obstetricians & Gynaecologists Singapore, Chapter of Haematologists College of Physicians Singapore.Venous thrombolism in pregnancy – Recommendation for prevention, treatment and investigation.March 2021. Available at: https:\/\/www.ams.edu.sg\/view-pdf.aspx?file=media%5C6016_fi_257.pdf&ofile=CPS-COGS+VTE+Consensus+Statement+2021+0326.pdf.Accessed October 2022.<\/p>\n","protected":false},"excerpt":{"rendered":"