恶性肿瘤伴发下肢深静脉血栓形成的机制及治疗对策探讨

A Study of the Mechanism and Treatment Strategics in Malignant Tumor Complicated by Deep Venous Thrombosis

目的 探讨恶性肿瘤伴发下肢深静脉血栓形成的机制及其治疗对策。方法 对 2 5例恶性肿瘤伴发下肢深静脉血栓形成的患者与随机选取的 2 5例健康成人进行血液流变学比较 ,并对此类患者的治疗过程进行回顾分析。结果 恶性肿瘤组的 ηb、ηp、Fib、HCT、ESR等五项指标均高于对照组 ,具有显著的统计学差异 (P <0 .0 1或 0 .0 5 ) ;在近期疗效上 ,经抗凝、溶栓、祛聚集治疗 3天后 ,病情好转率为 6 0 %。病情加重或无变化的患者 ,立即给予化疗 ,病情得到明显改善者占 90 %。结论 恶性肿瘤患者存在血液流变学变化 ,所导致的高凝状态易诱发下肢深静脉血栓的形成 ;在通过常规溶栓、抗凝、祛聚集等治疗无明显效果时 ,应考虑有癌栓的可能 ,应果断给予化疗。

Objective To study the pathogenetic mechanisms and treatment of malignant tumor complicated by deep venous thrombosis. Methods Twenty-five cases of malignant tumor complicated by deep venous thrombosis were compared with twenty-five cases of normal adults in the changes of hemorheology, and the treatment of these patients. were reviewed retrospectively. Results The indexes of hemorheology which include ηb、ηp、Fib、HCT、ESR were significantly higher in malignant tumor group than in normal adults group(P< 0.01 or 0.05).After the therapy of anti-coagulant, thrombolysis and desegregations, the effects in the near future show that the improve rate of patient's condition is 60 percent. Both the deteriorate patients and the no-change cases were offered chemotherapy immediately, the improve rate of patient's condition is 90 percents. Conclusion There are hemorheology changes in malignant tumor group,whose hypercoagulable state is apt to evoke the deep venous thrombosis. If there are no effects after routine therapy of anti-coagulant, thrombolysis and desegregation, we should think of the possibility of tumor embolism and should give them chemotherapy without hesitation.