妇科肿瘤术后并发深静脉血栓29例分析

Postoperative Deep Venous Thrombosis in Gynecologic Oncology: Clinical Analysis of Twenty-nine Cases

目的:探讨妇科肿瘤术后并发深静脉血栓(deep venous thrombosis,DVT)的诊治及预防。方法:回顾性分析29例妇科肿瘤术后并发DVT患者的临床资料。结果:本组恶性肿瘤25例,占86.2%,平均年龄56.8岁,平均体重指数27.9。经血浆D-二聚体检测并结合静脉彩超检查,确诊后采用全身或者局部抗凝、溶栓等药物治疗或手术取栓治疗;并发肺动脉栓塞(pulmonarythromboembolism,PE)患者放置临时性下腔静脉滤器(inferior vena cava filter,IVCF)预防致死性PE,效果满意。结论:恶性肿瘤、老年人、肥胖是妇科肿瘤术后DVT的高危因素,血浆D-二聚体检测结合静脉彩超可协助确诊,围手术期应积极预防DVT的发生,合理应用药物、介入和手术治疗可有效防治DVT。

Objective：Approach the diagnosis, treatment, and prophylaxis of postoperative deep venous thrombosis （DVT） in patients with gynecological tumor. Methods：The profiles of 29 cases with postoperative DVT in gynecologic oncology were analyzed retrospectively. Results： There were 25 cases of malignancy in this series which amounted for 86.2%. Their mean age was 56.8 years and the rrean body rre, ss index （BMI） was 27.9. Be diagnosed by plasma D-dimer detection and Doppler ultrasonography, they received systematic or local anticoagulation, thronblysis, or surgical thrombectomy treating. And temporary inferior vena cava filters （IVCFs） were applied for the suspected patients to prevent fatal pulmonary thromboembolism （PE）. All got satisfied effect. Conclusions： Malinant tumors, the aged, and obesity are high-risk factors for postoperative DVT in gynecological ocology. Combination of plasma D-dimer and Doppler ultrasonography is definitely the best choice for diagosis it. Pedoperative pro- phylatic treatment of DVT should be considered in high risk population. Proper medication, interventional therapy or operation can effectively prevent and cure DVT.