静脉血栓栓塞症预防与治疗湖南专家共识

Hunan expert consensus on the prevention and treatment of venous thromboembolism

摘要:

静脉血栓栓塞症（VTE）是住院患者常见且可预防的致死、致残性疾病。尽管国内已发布多部VTE相关指南，但针对临床实践中的部分关键细节问题，如特殊类型血栓的抗凝策略、下床活动时机、下腔静脉滤器应用及介入治疗指征等，仍缺乏统一、可操作性强的指导意见。为规范湖南省VTE防治工作，湖南VTE防治联盟联合湖南省药理学会血栓与止血药物专业委员会组织多学科专家，依据循证医学原则，采用推荐意见分级的评估、制订和评价（GRADE）证据评价体系和改良Delphi法制订本共识。共识围绕VTE预防与治疗中的12个临床问题，形成30条推荐意见，内容涵盖VTE全流程管理、D-二聚体应用、预防性抗凝疗程、机械预防、特殊类型血栓抗凝管理、下床活动管理、下腔静脉滤器应用及介入治疗等方面。旨在为湖南省各级医疗机构提供规范、统一、可操作的循证指导，促进区域VTE防治同质化建设，提高VTE防治水平。

Abstract:

Venous thromboembolism (VTE) is a major preventable cause of morbidity and mortality among hospitalized patients. Although several national guidelines have established general principles for the prevention and management of VTE, practical recommendations for many clinical scenarios remain insufficient, particularly regarding anticoagulation strategies for special thrombotic conditions, timing of ambulation, indications for inferior vena cava filter (IVCF) placement, and interventional therapies. To address these issues and meet regional clinical needs, the Hunan VTE Prevention and Control Alliance and the Special Committee of Thrombosis and Hemostatic Drugs of the Hunan Pharmacological Society convened a multidisciplinary expert panel to develop this consensus. The consensus was formulated in accordance with guideline-development standards using the GRADE approach and a modified Delphi process. A total of 12 key clinical questions were identified, and 30 recommendations were developed, covering VTE prevention, risk assessment, D-dimer application, pharmacological and mechanical prophylaxis, anticoagulation management for special thrombotic conditions, ambulation strategies, IVCF use, and interventional treatment. This consensus aims to provide evidence-based and practice-oriented recommendations for healthcare professionals across Hunan Province, promote standardized VTE management, and facilitate the establishment of a homogeneous regional VTE prevention and treatment system.