Moulder Janelle K, Siedhoff Matthew T, Till Sara R, Moll Stephan
aDepartment of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, University of North Carolina, Chapel Hill, North Carolina bDepartment of Obstetrics and Gynecology, Cedars Sinai Medical Center, Los Angeles, California cDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan dDepartment of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
Curr Opin Obstet Gynecol. 2016 Aug;28(4):329-35. doi: 10.1097/GCO.0000000000000286.
The purpose is to provide an update on management strategies for uterine fibroids in the setting of venous thromboembolism (VTE).
Uterine fibroids and VTE are independently associated with morbidity and increasing healthcare costs. Women with large uterine fibroids have a higher likelihood of VTE. Current strategies for stratifying patients with VTE take into account the nature of the VTE (i.e., truly provoked or unprovoked) and many patients may only require short-term anticoagulation. In those patients with risk factors for recurrent VTE, longer term anticoagulation may be required.
In women with large uterine fibroids, the likelihood of concurrent VTE increases. Peri and postoperative management should be determined based on patient-specific risk stratification, with the majority of patients requiring short-term anticoagulation. Further risk stratification may be required for patients with essentially an unprovoked VTE, and consultation with a thrombosis specialist is recommended.
目的是提供关于静脉血栓栓塞（VTE）情况下子宫肌瘤管理策略的最新信息。
子宫肌瘤和VTE均与发病率及医疗费用增加独立相关。患有大子宫肌瘤的女性发生VTE的可能性更高。当前对VTE患者进行分层的策略考虑了VTE的性质（即真正的诱发或非诱发），许多患者可能仅需要短期抗凝治疗。对于那些有复发性VTE危险因素的患者，可能需要长期抗凝治疗。
在患有大子宫肌瘤的女性中，并发VTE的可能性增加。围手术期管理应根据患者的具体风险分层来确定，大多数患者需要短期抗凝治疗。对于基本为非诱发VTE的患者，可能需要进一步的风险分层，建议咨询血栓形成专家。
