《胸部恶性肿瘤围术期静脉血栓栓塞症预防中国专家共识（2018版）》解读之围术期高凝状态篇

Perioperative Venous Thromboembolism(VTE) Prophylaxis in Thoracic Cancer Patients: Chinese Experts Consensus-Interpretation of Perioperative Hypercoagulable State

静脉血栓栓塞症(venous thromboembolism,VTE)是肺癌围术期常见的并发症,也是导致院内非预期死亡的重要原因。VTE临床相关的高危因素包括:患者自身的因素(高龄、肥胖等)、肿瘤相关因素(分型、分期等)、治疗相关因素(化疗、手术等)。除此之外,肿瘤细胞会表达癌性促凝因子(cancer procoagulant,CP)、组织因子(tissuefactor,TF)、炎症因子等,或是激活血小板、炎性细胞等相关细胞,直接或间接地活化凝血过程,引起血液高凝状态,从而促进VTE的发生。同时,相关的生物标记物也可反映肺癌患者围术期的凝血状态,这有助于更准确地筛选VTE高危患者,更精准地予以预防策略。

Venous thromboembolism(VTE) is a common perioperative complication of lung cancer and a major cause of unexpected death in hospital.The clinical risk factors of VTE include:patients’ factors(advanced age,obesity,etc.),tumor-related factors(classification,staging,etc.),treatment-related factors(chemotherapy,surgery,etc.).In addition,tumor cells express cancer procoagulant(CP),tissue factor(TF),inflammatory factors or activate platelets,inflammatory cells and other related cells,directly or indirectly activate the coagulation process,and cause blood hypercoagulable state,thus promote the occurrence of VTE.At the same time,the relevant biomarkers can also reflect the perioperative coagulation status of patients,which is helpful to more accurately identify high-risk subgroups to establish more accurate and targeted anticoagulation strategies to prevent thrombosis in lung cancer patients.