胃癌患者术后静脉血栓栓塞症的防治现状与展望

Prevention and treatment of postoperative venous thromboembolism in patients with gastric cancer

胃癌是全世界内最常见的癌症之一,手术切除是其主要治疗方式。静脉血栓栓塞症(VTE)包括深静脉血栓形成(DVT)和肺栓塞(PE),是胃癌患者术后重要并发症。VTE作为癌症患者预后的独立危险因素,及时有效的治疗方式不仅会降低患者的治疗成本,更会明显改善患者的生存质量。现有关于胃癌术后VTE的治疗指南多是基以欧美人群的研究为主,而亚洲医生普遍认为亚洲胃癌患者术后VTE发生率较低,为权衡患者出血风险,指南推荐的抗凝治疗策略实行率并不高。本文旨在综述并探讨胃癌术后VTE治疗的相关问题,讨论近些年来相关研究所带来的新启发,旨在为一线医生对胃癌患者术后的抗凝治疗带来一些思考。

Gastric cancer is one of the most common cancers within the world and surgical resection is its main treatment modality.Venous thromboembolism(VTE),which includes deep vein embolism(DVT)and pulmonary embolism(PE),is an important postoperative complication for patients with gastric cancer.As an independent risk factor for cancer patients’prognosis,timely and effective treatment modalities will not only reduce patients’treatment cost,but also significantly improve patients’survival quality.The existing guidelines for the treatment of postoperative VTE in gastric cancer are mostly based on studies in the European and American populations,while Asian physicians generally believe that the incidence of postoperative VTE is lower in Asian gastric cancer patients,and the implementation of anticoagulation strategies recommended by the guidelines is not high in order to weigh the bleeding risk of patients.The purpose of this article is to review and discuss issues related to postoperative VTE treatment in gastric cancer and to discuss new insights from relevant studies in recent years,with the aim of bringing some thoughts to frontline physicians on postoperative anticoagulation treatment for gastric cancer patients.