恶性肿瘤合并静脉血栓形成74例临床分析

Analysis of related factors of malignant tumor complicated with venous thromboembolism in 74 cases

目的：分析恶性肿瘤合并静脉血栓栓塞症（VTE）的相关因素，为恶性肿瘤合并VTE的早期预防及治疗提供临床依据。方法收集恶性肿瘤合并VTE患者74例，回顾性分析其临床资料。结果在74例肿瘤合并 VTE 患者中，男性多于女性，45～80岁50例（67．57％）。发生 VTE 最多的病种是肺癌27例（36.49％）；既往有深静脉血栓栓塞、手术病史或者合并高血压的患者都易于发生 VTE，分别是14例（18.92％）、12例（16．22％）、11例（14．86％）；57例（77．03％）VTE 患者曾行放疗和／或化疗；血小板计数、D-二聚体、纤维蛋白原、C反应蛋白（CRP）与肿瘤合并VTE 均有一定相关性。74例患者均接受了抗血栓治疗，其中67例（90．54％）主要通过药物抗凝治疗。结论肿瘤合并VTE 与患者的年龄、肿瘤病种、放／化疗史，既往病史以及凝血相关指标有关。了解肿瘤合并血栓的形成高危因素，有助于对VTE的预防、早期诊断与治疗，降低病死率。

Objective To discuss the related factors of the malignant tumor complicated with venous throm-boembolism（VTE）,which may provide the clinical evidence for prevention,diagnosis and treatment of this disease. Methods Retrospectively reviewed the clinical data of patients with malignant tumor who were diagnosed with VTE from June 2012 to June 2015 in our hospital.Results Among 74 cases with tumor merger VTE,female with thrombosis was higher than the male.67.57% of the tumor with VTE patients was 45 -80 years old.Lung cancer patient with VTE was the highest almost 36.49%.Patients with deep vein catheterization,a history of surgery or merging of hyper-tension were easy occurred VTE,those were 14 cases （18.92%）,12 cases （16.22%）and 11 cases （14.86%） respectively.57 VTE patients underwent radiotherapy or chemotherapy treatment.The platelet count,D -dimer, fibrinogen and CRP were associated with thrombosis.Among 74 cases with VTE,67 cases （90.54%）accepted anticoagulation therapy.Conclusion Sex,tumor disease,chemotherapy or radiotherapy treatment,medical history and coagluative function index were associated with VTE.Early diagnosis and treatment is the key to reduce mortality and improve prognosis of malignant tumor with VTE.