宫颈癌合并深静脉血栓30例临床分析

Clinical analysis of the relation of uterine cervix cancer and thromboembolic disease in 30 cases

目的:静脉血栓栓塞症(VTE)是恶性肿瘤患者常见并发症。本文结合文献分析我院住院病人宫颈癌患者静脉血栓的临床特征,分析VTE形成机制及诱发因素,探索最佳治疗方法。方法:对近5年我科收治的宫颈癌合并深静脉血栓30例患者的临床资料进行分析。结果:30例患者中17例VTE的发生和介入手术化疗有关。2例(6.7%)血栓栓塞发生在宫颈癌确诊之前,28例(93.3%)发生在宫颈癌确诊之后,单纯并发下肢深静脉血栓形成(DVT)27例,合并肺栓塞(PTE)2例,DVT合并PTE 1例。22例在栓塞前有化疗史。结论:血栓可能为肿瘤病人的首发表现,病人出现不能解释的血栓栓塞性疾病应考虑有肿瘤的可能。抗凝治疗对于血栓栓塞症疗效确切。及时诊断和治疗可以延长患者的生存期,降低患者的死亡率。口服避孕药、口服甲地孕酮、介入手术与VTE的发生几率可能有关。分期晚,远地转移的肿瘤患者易出现血栓栓塞。

Objective：Venous thromboembolism（VTE）is the common complication in malignant tumor patients.Methods：Clinical data of 30 patients of uterine cervix cancer with TD confirmed by pathology and cytology in recent 5 years were analyzed.Results：Of 30 cases 17（56.67%）of VTE had relation with intervention operation.2 cases（6.7%）of VTE occurred before diagnosis of uterine cervix cancer.28 cases（93.3%） after diagnosis of uterine cervix cancer.There were 27 cases with only deep venous thrombosis（DVT）,2 cases with only pulmonary thromboembolism（PTE）,1 case with DVT and PTE,22 cases had chemotherapy history.Conclusion：VTE sometimes is the first representation in cancer patients.If VTE occurred and can not be complained for some common motivations,we should consider neoplasm.anticoagulant therapy is the best therapeutics for VTE,early diagnosis and right treatment can lengthen the life span.oral contraceptives or megestrol and accepting intervention operation may have correlation with VTE.advanced stage,metastatic tumor may easily occur VTE.