胃癌合并静脉血栓栓塞症的临床分析

Clinical analysis of gastric cancer complicated with venous thromboembolism

目的探讨胃癌合并静脉血栓栓塞症(venous thromboembolism,VTE)的临床特征、发病情况及防治情况,旨在提高对VTE的防治意识,减少静脉血栓形成。方法回顾性分析华中科技大学同济医学院附属协和医院2009年12月至2017年10月收治的44例胃癌合并VTE患者的临床资料,分析其临床特点、发病情况及防治情况。结果44例胃癌合并VTE患者中,男27例,女17例,年龄(53.66±10.61)岁(26~82岁)。胃腺癌37例(84.09%);Ⅳ期25例(56.82%),Ⅲ期13例(29.55%)。39例(88.64%)VTE发生于胃癌确诊后,其中确诊6个月内累计发生26例。15例VTE患者确诊后曾行PICC置管,其中置管1个月内累计发生VTE 10例(66.67%)。27例曾接受手术,术后6个月内发生VTE 25例(92.59%)。29例接受化疗,化疗后6个月内发生VTE 18例(62.07%)。3例接受放疗,放疗后6个月内发生VTE 2例(66.67%)。结论胃癌确诊6个月内、PICC置管1个月内及术后、化疗、放疗后6个月内是VTE高发期,需引起警惕。

Objective To investigate the clinical characteristics,incidence and prevention of gastric cancer complicated with venous thromboembolism(VTE),in order to improve the awareness of prevention and treatment of VTE and reduce venous thrombosis.Methods The clinical data of 44 patients with gastric cancer complicated with VTE admitted to Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from Dec.2009 to Oct.2017 were retrospectively analyzed.Their clinical characteristics,incidence and treatment were analyzed.Results Of all 44 patients,there were 27 males and 17 females with age of(53.66±10.61)years old(ranging from 26 to 82 years old).Adenocacinoma was identified in 37 patients(84.09%),25 patients(56.82%)were in stageⅣand 13 patients(29.55%)were in stageⅢ.39 cases(88.64%)of VTE occurred after the diagnosis of gastric cancer,of which 26 cases occurred in 6 months.15 patients with VTE underwent PICC catheterization after diagnosis,of which 10 patients(66.67%)had VTE in 1 month.VTE occurred in 25 cases(92.59%)within 6 months after operation.29 cases received chemotherapy,and 18 cases(62.07%)developed VTE within 6 months after chemotherapy.3 cases received radiotherapy,and 2 cases(66.67%)developed VTE within 6 months after radiotherapy.Conclusion The high incidence of VTE is within 6 months after the diagnosis of gastric cancer,1 month after PICC catheterization,and 6 months after surgery,chemotherapy and radiotherapy.