恶性肿瘤患者高凝状态与血栓形成的临床研究

Clinical research on high coagulation state and thrombosis in patients with cancer

目的探讨恶性肿瘤患者高凝状态与血栓形成的临床表现、危险因素和治疗情况,以期提高临床治疗水平。方法回顾性分析2008年1月至2012年1月间收治的393例恶性肿瘤患者,对其中40例出现高凝状态或血栓形成患者的临床表现、危险因素和治疗等情况进行总结。结果恶性肿瘤患者高凝状态与血栓形成临床症状以患肢肿痛、髂窝股三角区疼痛和压痛、皮温升高为主;实验室检查以D-2聚体、凝血酶原时间、活化部分凝血酶时间升高为主;超声表现为实质性回声,CT表现为动脉充盈缺损。高凝状态与血检形成的危险因素有置管、升白治疗、卧床和手术(P<0.05),其形成时间以治疗后2个月内为主,占全部的77.5%。临床治疗总有效率为85.0%。结论高凝状态与血栓形成与恶性肿瘤患者的治疗等有关,抗凝治疗后预后较好。

Objective To investigate the hypercoagulable state in patients with cancer and thrombosis in clinical manifestations, risk factors and treatment in order to improve the level of clinical treatment. Methods A retrospective analysis in January 2008 -2012 in January 393 cases of cancer, 40 cases of them appear to have a hypercoagulable state or thrombosis in patients from the clinical manifestations, risk factors and treatment summary of the situation. Results Cancer patients hypereoagulable state and thrombosis symptoms were limb pain, femoral triangle ifiac fossa pain and tenderness, skin temperature based; laboratory tests to D-2 dimer, prothrombin time, activated partial thromboplastin time increased mainly ultrasound showed substantial echo, CT showed arterial filling defect; risk factors were catheter, elevated white blood cell therapy, in bed and surgery （P 〈0. 05） ; formation time in two months, accounting for 77.5% of total; clinical total effective rate was 85.0%. Conclusion The hypercoagulable state of cancer patients and pa- tients with thrombosis treatment related to anticoagulant therapy better prognosis.