动态监测D-二聚体在肿瘤患者导管相关性血栓的临床意义

Clinical significance of dynamic monitoring of D-dimer in catheter related thrombosis of cancer patients

目的探讨D-二聚体水平与肿瘤患者导管相关性血栓(Catheter related thrombosis,CRT)发生的相关性。方法对100例住院的深静脉置管肿瘤患者进行前瞻性研究,动态监测血浆D-二聚体以及静脉多普勒超声检查,观察CRT的发生率、发生时间及血栓类型等。结果CRT的发生率为12.6%,其中无症状血栓占83.3%。58.3%的血栓发生在置管后2周内,91.7%发生在置管后的置管后4周内。置管后2周血栓组D-二聚体水平显著高于非血栓组( P =0.013)。结论肿瘤患者CRT大部分形成于深静脉置管后4周内,其中无症状性血栓的比例高,动态监测D-二聚体可能有助于其早期诊断。

Objective The objective of this study was to investigate the correlation between D-dimer levels and the occurrence of catheter related thrombosis(CRT)in tumor patients.Methods A prospective study was performed on 100 cancer patients with deep venous catheterization.The plasma D-dimer and intravenous Doppler ultrasonography were used to observe the incidence,time and thrombus type of CRT.Results The incidence of CRT was 12.6%,and asymptomatic thrombosis accounted for 83.3%.58.3% of the thrombosis occurred within 2 weeks after catheterization,and 91.7% occurred within 4 weeks after catheterization.After 2 weeks of catheterization,the level of D-dimer in the thrombosis group was significantly higher than that in the non-thrombosis group( P =0.013).Conclusion Most of the CRT in tumor patients is formed within 4 weeks after deep venous catheterization.The proportion of asymptomatic thrombus is high,and dynamic monitoring of D-dimer may be helpful for early diagnosis.