尿激酶治疗恶性肿瘤并发深静脉血栓的临床疗效观察

Observation of Clinical Efficacy of Malignancy Complicated by Deep Venous Thrombosis Treated with Urokinase

目的:观察尿激酶对恶性肿瘤伴发深静脉血栓形成(DVT)的治疗效果并探讨其可能的发病机理。方法:对41例在放化疗期间并发DVT的恶性肿瘤患者以尿激酶600IU/(kg.d)静脉泵入进行溶栓治疗,观察其疗效,并分析其临床特点、化疗方案等。结果:溶栓治疗总有效率65.8%,治疗前后血浆D-二聚体阳性率分别为85.4%及9.8%(P<0.05),其中1例患者于治疗开始后第4天发生急性肺栓塞死亡。39例(95.1%)患者接受了化疗,使用频率较高的药物为DDP(66.7%)、NVB(41.0%)、5-Fu(17.9%)。结论:尿激酶溶栓疗法对恶性肿瘤合并的DVT有一定疗效,急性肺栓塞是值得重视的严重不良反应。化疗药物可能是恶性肿瘤患者DVT形成的可能机制之一。

OBJECTIVE： To observe thrombolytic effect of urokinase （UK） on malignancy complicated by deep venous thrombosis （DVT）, and analyze its probable pathogenesy. METHODS： 41 cases with malignancy complicated by DVT during radiotherapy and chemotherapy were given thrombolysis therapy with urokinase （600IU/（kg· d）, pumped from vein）. Their curative effect was observed and clinical features and chemotherapy program were analyzed. RESULTS： Total effective rate of thrombolysis therapy was 65.8 %, positive rate of plasma D - dimer before and after treatment was 85.4 % and 9.8 %, respectively （ P 〈 0.05）. One case of them died of acute pulmonary embolism at the 4th days after beginning the therapy. 39 cases（95.1% ） accepted chemotherapy, drugs used in high frequency were DDP （ 66.7 % ）, NVB （41.0 % ） and 5 - Fu （17.9%）. CONCLUSION： Thrombolysis therapy with urokinase has a certain effect on malignancy complicated by DVT, but acute pulmonary embolism is the severe and notable adverse reaction. Drugs used for Chemotherapy are probably the pathogenetic factors of DVT in the patients with malignancy.