恶性实体瘤合并深静脉血栓形成64例临床分析

A Clinical Analysis on 64 Cases of Malignant Solid Tumor with Deep Vein Thrombosis

目的：探讨恶性实体瘤并发深静脉血栓形成（DVT）的临床特点、危险因素、诊断治疗方法及预后。方法回顾性分析64例恶性实体瘤合并DVT患者的临床资料，分析总结肿瘤的临床特点与DVT之间的关系。结果该组患者DVT好发于下肢（73.4%），尤其是左下肢（43.8%），以股静脉栓塞最常见。肿瘤原发部位以肺癌最多见（37.5%），其次为胃癌、肝癌、结直肠癌、胰腺癌。病理类型以腺癌最多见（70.3%）。该组患者中Ⅱ期7例（10.9%），Ⅲ期24例（37.5%），Ⅳ期33例（51.6%）。治疗以抗凝为主，部分患者视病情进行溶栓。发生栓塞后患者中位生存期为5个月。结论恶性实体瘤与DVT事件的发生密切相关。恶性肿瘤合并DVT的患者预后不良，对该类患者应及时发现并尽早干预。

Objective To investigate the characteristics, diagnosis, treatment and prognosis in patients with malignant solid tumor and deep vein thrombosis （DVT）. Methods Retrospective analysis on 64 patients with malignant solid tumor and DVT. Results DVT was more often in lower limb （73.4%）, especially in left lower limb （43.8%）. Femoral venous embolism was the most common. In 64 cases, 37.5% was lung cancer, 18.8%was gastric cancer, 9.4%was liver cancer, 9.4%was colorectal cancer, 4.7%was pancreatic cancer. Patients with adenocarcinoma type accounted for 70.3%. In all these cases, 10.9%was stageⅡ, 37.5%was stageⅢand 51.6%was stageⅣ. The major treatment involved anticoagulation and/or thrombolysis. The median OS of these patients was only 5 months after DVT. Conclusion Patients with malignant solid tumor have a higher risk of DVT. Patients with malignant solid tumor and DVT have poor prognosis and should be given early diagnosis. Aggressive treatment should be given to these patients.