Abstract:

Today，the incidence and mortality of perinatal thromboembolic diseases show a significant upward trend，which is mainly caused by venous thrombosis after cesarean section.Cesarean section has been identified as a high-risk factor for venous thromboembolism，which is not only related to surgical factors，but also to pathological obstetric factors in most cesarean sections.It is generally believed that the risk of bleeding after anticoagulant therapy after cesarean section is greater，so most postoperative anticoagulant therapy is not performed.However，with the increase of high-risk maternity，in order to minimize the adverse outcome，we should evaluate the risk of bleeding and thrombosis after cesarean section and the reasonable preventive anticoagulant therapy for high-risk women.By summarizing the related literature，this paper discusses how to assess the risk of thrombosis after cesarean section and effectively prevent thromboembolic events in order to determine the best time to perform anticoagulation prevention intervention.

Key words: cesarean section, deep venous thrombosis, pulmonary thromboembolism, anticoagulant therapy, low molecular-weight heparin

摘要：

目前，围产期血栓栓塞性疾病发病率及病死率呈显著上升趋势，这多是继发于剖宫产术后形成的静脉血栓。剖宫产现已明确为静脉血栓栓塞症高危因素，这不仅与手术因素相关，也与大多数剖宫产合并病理产科因素相关。目前，普遍认为剖宫产术后抗凝治疗的出血风险大于收益，因此，术后多数并未进行预防性抗凝治疗。但随着高危产妇增多，为求最大程度降低不良结局，应权衡剖宫产术后出血及血栓风险，合理对高危产妇进行预防性抗凝治疗。文章从临床角度，总结国内外相关文献，探讨剖宫产术后如何评估血栓风险，并对血栓栓塞事件的有效预防，以确定选择抗凝预防干预的最佳时机进行探讨。

关键词: 剖宫产, 深静脉血栓, 肺动脉血栓栓塞症, 抗凝治疗, 低分子肝素