妇科肿瘤合并急性下肢深静脉血栓形成14例临床分析

Clinical Analysis of the Gynecologic Oncology with Acute Deep Venous Thrombosis of Lower Extremities

目的:研究妇科肿瘤合并急性下肢深静脉血栓(DVT)形成的危险因素、临床特点和诊治方法。方法:回顾性分析我院1 4例妇科肿瘤合并急性下肢DVT患者的临床资料。结果:1 4例中4例恶性肿瘤,3例发展为肺栓塞。1 3例经彩超检查确诊。9例手术取栓,其中4例妇科手术同时外科取栓治疗;5例保守治疗。1 3例治疗后好转出院,1例死亡。结论:妇科肿瘤合并DVT应引起充分重视,彩超检查有助于DVT的诊断。急性DVT保守或手术治疗均有效。如DVT与妇科肿瘤有关,可在妇科手术同时行取栓术,联合抗凝、溶栓、祛聚、扩血管等综合治疗,防止血栓再发和促进后期再通。对有高危因素者手术前后应预防性应用抗凝剂。

Objective: To study the risk factors and clinical characteristics of deep vein thrombosis (DVT) on Gynecologic tumor,as well as diagnosis, treatment, and prevention of DVT. Methods: The medical records of 14 patients with gynecologic tumors and DVT treated in Peking University Third Hospital from Jan 1994 to Dec 2003 were analyzed retrospectively. Results: The average age of these patients was 55.2 year-old. 13 cases were diagnosed by Colour code Doppler ultrasonography. DVT occurred more frequently in left leg. 9 cases underwent surgical thrombectomy while 4 cases got thrombectomy while gynecologic operation.5 patients received anticoagulation therapy. 4 cases were malignant tumor. Among them, 3 cases development PTE and One died. Recovery was achieved in 13 patients. Conclusions: Gynecologic Oncology with Acute DVT should be pay attention. Colour ultrasonography is useful for diagnosis. Conservative therapy or surgical intervention is effective for acute DVT. If DVT is caused by pelvic tumor, surgery for gynecologic tumor and thrombectomy can be done at same time. Prophylatic anticoagulation treatment should be considered in high-risk population.