恶性肿瘤合并静脉血栓的临床分析

Clinical analysis of malignant tumor complicated with venous thrombosis

目的:探讨恶性肿瘤合并静脉血栓的临床治疗方法以及治疗效果。方法:收集我院2014年10月—2017年10月收治的40例恶性肿瘤合并静脉血栓患者的临床资料,分为观察组:对其采用利伐沙班抗凝治疗。对照组:对其采用低分子肝素钙联合华法林抗凝治疗,观察患者治疗后的凝血功能指标以及患者治疗效果。结果:观察组治疗总有效率为90.0%。对照组治疗总有效率为90.0%。观察组治疗效果与对照组疗效相当。观察组治疗前后PT、APTT、INR无明显变化;对照组治疗前后PT、APTT、INR较前明显升高,差异存在统计学意义(P <0.05),INR平均治疗达标时间为5.2天。结论:利伐沙班与低分子肝素钙联合华法林治疗恶性肿瘤合并静脉血栓,疗效相当。利伐沙班组治疗前后凝血功能无变化。低分子肝素钙联合华法林组治疗前后凝血功能变化明显,出血风险增加,治疗过程需监测凝血常规。

Objective:To investigate the clinical treatment and treatment effect of malignant tumor complicated with venous thrombosis.Methods:Clinical data of 40 patients with malignant venous thrombosis who were admitted to our hospital from October 2014 to October 2017 were collected and divided into the observation group who received anti-coagulation therapy with rivaroxaban and the control group,who was treated with low-molecular-weight heparin sodium and warfarin anticoagulant therapy,the coagulation function index after treatment and the patient's treatment effect were observed.Results:The total effective rate of the observation group was 90.0%.The total effective rate of treatment in the control group was 90.0%.The therapeutic effect of the observation group was comparable to that of the control group.There was no significant change in PT,APTT,and INR before and after treatment in the observation group.The PT,APTT,and INR were significantly higher in the control group after treatment,and the difference was statistically significant(P<0.05).The standard time of INR was 5.2 days.Conclusions:The efficacy of rivaroxaban combined with low-molecular-weight heparin sodium and warfarin for the treatment of malignant tumors with venous thromboembolism was comparable.There was no change in coagulation function before and after treatment in the rivaroxaban group.The low-molecular-weight heparin sodium and warfarin group had significant changes in coagulation function before and after treatment,and the risk of bleeding increased.The coagulation routine was monitored during the treatment.