Objective: To evaluate the quality of the current foreign clinical practice guidelines (CPG) on obstetric venous thromboembolism (VTE), providing reference for standardizing the prevention and treatment of domestic VTE clinical practice. Methods: The GPGs for the management of obstetric VTE published abroad from inception to July 2020 were electronically searched. Two researchers independently evaluated the quality of the included guidelines in accordance with the internationally recognized guideline evaluation tool, AGREE Ⅱ. Results: A total of 12 guidelines, 2 recommendations and 1 consensus for obstetric VTE were included, covering 3 continents and 9 countries, and the published time span was 2009-2020. The standardized scores of the six domain (scope & purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability and editorial independence) included in the guidelines were: 99.44%, 62.78%, 70.35%, 95.74%, 68.80% and 76.94% respectively, and the scores in each domain were ≥ 50.00%, indicating that the included CPGs were of good quality. Except for the domain scope & purpose, the ranges of the other five domains were ≥ 50.00%, suggesting that the quality of the CPGs differed significantly. Among the 15 included CPGs, 4 CPGs were level A (recommended), 11 CPGs were level B (recommended after being revised), and there was no CPG in level C (not recommended). The difference in the recommended content of obstetric VTE management mainly focused on the risk assessment, drug type, dosage and period. Conclusions: The overall quality of the CPGs for obstetric VTE management is high, while the quality of the CPGs varies greatly. In addition, there are differences in the recommended content of obstetric VTE management. More high-quality researches are required to provide evidence-based support for the improvement of the CPGs.
目的: 对目前多个产科静脉血栓栓塞症(VTE)的国外临床实践指南(CPG)进行质量评价,为规范我国产科VTE的临床实践提供参考。 方法: 通过计算机检索建库至2020年7月国外公开发表的、专门针对孕产妇VTE管理的CPG。由两名研究员按照国际公认的指南评价工具——AGREE Ⅱ分别对纳入CPG进行质量评价。评价领域包括范围和目的、参与人员、严谨性、清晰性、应用性、独立性,CPG的推荐级别由以上6个领域的标准化总分的分布情况确定。 结果: 共纳入产科VTE指南12篇,推荐2篇,共识1篇,覆盖3个洲9个国家,发布时间为2009—2020年。纳入指南的范围和目的、参与人员、严谨性、清晰性、应用性及独立性6个领域的平均标准化评分分别为99.44%、62.78%、70.35%、95.74%、68.80%、76.94%,各领域的标准化评分均≥50.00%,提示纳入CPG的总体质量较高。除范围和目的外,其余5个领域的全距(标准化评分的最大值与最小值之差)均≥50.00%,提示各CPG之间的质量差异较大。15篇CPG中,A级(推荐)4篇,B级(修改完善后推荐)11篇,C级(不推荐)0篇。产科VTE管理推荐内容的差异主要体现在风险评估、药物种类、剂量和疗程几方面。 结论: 孕产妇VTE防治CPG的总体质量较高,但各CPG间的质量差异较大,尚需要更多的高质量研究为其完善提供依据。.