《2011RCOG靜脈血栓栓塞和激素替代療法》內容簡介:
Exogenous estrogens used in the combined oral contraceptive pill have long been recognised as causativefactors in the pathogenesis of venous thromboembolism (VTE)。1,2Hormone replacement therapy (HRT),either sequential or continuous combined, also exposes women to exogenous estrogen and a number ofcase–control studies and prospective randomised trials have shown an increase in the relative risk of VTE inwomen on estrogen-containing HRT.3In particular, the Women's Health Initiative (WHI) study in the USAassessed the major health benefits of oral HRT (0.625 mg conjugated equine estrogen and 2.5 mgmedroxyprogesterone acetate [MPA] daily) in a randomised placebo-controlled clinical trial with more than8000 women in each arm and confirmed an increase in the risk of pulmonary embolism (hazard ratio 2.13,95% CI 1.39–3.25)。4On the available evidence, however, a substantial risk of VTE may relate only to oral andnot to transdermal preparations.3Thus, the risk of VTE and the type of preparation must be considered inwomen starting or continuing HRT.
《2011RCOG靜脈血栓栓塞和激素替代療法》內容預覽:
This guideline was developed using the standard methodology for developing RCOG Green-top Guidelines.5–7Original articles for the evidence base for this guideline were obtained following a computer search for'hormone replacement' as a keyword and also in combination with 'venous thrombosis' or 'deep venousthrombosis' (DVT) or 'pulmonary embolism' or 'thrombophilia' applied to Medline (1966 to week 1, 2010),Embase (1980 to week 1, 2010), Evidence-based Medicine Reviews, the Cochrane Database of SystematicReviews and the Database of Abstracts of Reviews of Effectiveness to the last quarter of 2009. This wascomplemented by hand searching for individual references identified from these original articles.The levelsof evidence and the grade of recommendations used in this guideline are detailed in RCOG ClinicalGovernance Advice No. 1a–c.5–7Where possible, recommendations are based on, and explicitly linked to, theevidence that supports them.Areas lacking evidence are highlighted and annotated as good practice points.
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