目的:本临床实践指南的主要目的是为妇科医生提供指导在妇科手术中使用血栓预防的算法和证据。
方法:所有因良性或恶性适应症而接受妇科手术的患者。
结果:本指南的实施将使接受妇科手术的患者受益,并为医生提供围手术期血栓预防的标准算法。
方法:在MEDLINE中输入了以下搜索术语,谷歌学者,和Cochrane在2017年和2018年:VTE,PE,DVT,血栓预防,妇科手术,肝素,渐变压缩长袜,间歇性气动长袜,肥胖,儿科,微创手术,肝素诱导的血小板减少症,区域麻醉)。纳入的文章均为随机对照试验,荟萃分析,系统评价,和观察性研究。从这些文章的参考列表中确定了其他出版物。没有日期限制,但搜索结果仅限于英语文章。直到2018年9月,搜索都已更新并纳入指南。
方法:作者使用建议分级评估对证据质量和建议强度进行了评估,开发和评估(等级)方法。见在线附录A(表A1的定义和A2的强和弱的建议的解释)。
■妇科医生和外科团队的其他成员。建议(家长的等级评定)。
OBJECTIVE: The primary objective of this clinical practice
guideline is to provide gynaecologists with an algorithm and evidence to guide the use of thromboprophylaxis in gynaecological surgery.
METHODS: All patients undergoing gynaecological surgery for benign or malignant indications.
RESULTS: The implementation of this
guideline will benefit patients undergoing gynaecological surgery and provide physicians with a standard algorithm for the use of perioperative thromboprophylaxis.
METHODS: The following search terms were entered into MEDLINE, Google Scholar, and Cochrane in 2017 and 2018: VTE, PE, DVT, thromboprophylaxis, gynaecological surgery, heparin, graduated compression stocking, intermittent pneumatic stocking, obesity, pediatrics, minimally invasive surgery, heparin induced thrombocytopenia, regional anesthesia). Articles included were randomized controlled trials, meta-analyses, systematic reviews, and observational studies. Additional publications were identified from the reference lists of these articles. There were no date limits, but search results were limited to English language articles only. Searches were updated and incorporated into the
guideline up to September 2018.
METHODS: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations).
UNASSIGNED: Gynaecologists and other members of the surgical team. RECOMMENDATIONS (GRADE RATINGS IN PARENTHESES).