肺癌与血栓栓塞性疾病关系的临床分析  

Clinical analysis of the relation of lung cancer and thromboembolic disease

作　　者：邸庆国[1] 李桂馨[1] 孙宝华[1] 康筱玲[1] 吴坎金[1] 周丽荣[1] 

机构地区：[1]沧州市中心医院呼吸科,河北沧州061000

出　　处：《临床肺科杂志》2010年第5期685-686,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的提高临床医生对肺癌合并血栓栓塞性疾病的认识。方法对近5年经病理或细胞学证实的肺癌合并血栓栓塞性疾病患者的临床资料进行分析。结果本组患者中16例为腺癌。9例(52.94%)血栓栓塞发生在肺癌确诊之前,8例(47.06%)发生在肺癌确诊之后,其中13例(76.67%)肺癌确诊时间分布于栓塞前后120天。单纯并发下肢深静脉血栓形成(DVT)7例,单纯肺血栓栓塞(PTE)4例,DVT合并PTE 6例。10例合并PTE患者中8例(80%)有较典型的临床症状,9例(90%)表现为双肺多发栓塞,大多有低氧血症、血D二-聚体明显升高。心电图仅1例有典型SⅠQⅢTⅢ表现。8例在栓塞前有化疗史。结论病人出现不能解释的血栓栓塞性疾病应考虑有肿瘤的可能,腺癌患者易并发血栓栓塞性疾病。化疗是肺癌合并血栓栓塞性疾病的高危因素之一。及时诊断和治疗可以降低患者的死亡率。临床医生应提高对肺癌合并血栓栓塞性疾病的认识。Objective To increase the clinicians＇awareness about lung cancer complicating thrombosis disease（TD）. Methods The clinical data of patiens of lung cancer with TD confirmed by pathology and cytology in the recent 5 years were analyzed. Results The pathology of 16 cases of lung cancer with TD was adenocarcinoma in the group. There were 7 cases with only deep venous thrombosis （DVT） ,4 cases with only pulmonary thromboembotism（PTE） ,6 cases with DVT and PTE. 9 cases（52.94% ） of DVT/FFE before detection of lung cancer. 8 eases（47.06% ） of DVT/PTE occurred after detection of lung cancer. There were 13 （76.67%） cases occurred TD around 120 days when the cases were confirmed with lung cancer. Of the 10 cases of lung cancer complicating TD,there were 8 cases with typical cliniel symptom and there were 9 cases with thromboembolism in two lungs. Most eases had hypoxemia and high D-Dimer. There was only l case with typical behavation of ECG of SⅠQⅢTⅢ in the group. There were 8 cases with the history of chemotherapy. Conclusion Cancer must be considered when the patients over 50 years old and have unexplained thromboembolism. The most common physiologic type of lung cancer complicating TD is adenocarcinoma. Chemotherapy is one of the most important dangerous factors of thromboembolism. It can reduce the mortality if the diagnosis and the treatment are conducted in time. Clinical doctors must increase the awareness of lung cancer complicating TD.

关 键 词：肺癌 血栓栓塞 

分 类 号：R734.2[医药卫生—肿瘤]