恶性肿瘤合并肢体深静脉血栓形成:附45例报告  

Malignant neoplasms with limb deep venous thrombosis:a report of 45 cases

作　　者：方宏超[1] 郭学利[1] 符洋[1] 张勇敢[1] 张闯[1] 梁冰[1] 

机构地区：[1]郑州大学第一附属医院血管外科,河南郑州450000

出　　处：《中国普通外科杂志》2012年第6期667-670,共4页China Journal of General Surgery

摘　　要：目的:探讨恶性肿瘤患者合并肢体深静脉血栓形成(DVT)的临床特点及治疗方法。方法:回顾近年收治的45例合并DVT的恶性肿瘤患者的临床资料,总结、分析血栓形成的机制及防治措施。结果:38例(84.4%)患者经正规抗凝溶栓治疗后,临床症状缓解,其中1例出现皮下淤血;4例(8.9%)抗凝溶栓过程中出现肺栓塞(PE),其中3例抢救后肺栓塞症状基本缓解,1例抢救无效后死亡;3例患者因出血风险仅给予制动、对症及活血药物治疗后症状缓解。8例与外周中心静脉导管(PICC)置入有关的上肢DVT患者治疗后,根据不同情况分别拔除导管,未出现明显PE症状。结论:恶性肿瘤患者需警惕DVT形成,确诊后应积极治疗。对无明显诱因的DVT患者要高度警惕并存恶性肿瘤的可能。Objective： To investigate the clinical features and management of deep venous thrombosis （DVT） in patients with malignant tumor. Methods： The clinical data of 45 patients with malignant tumor and complicated by DVT were reviewed to summarize and analyze the causes, prevention and treatment methods of thrombosis of these patients. Results： Of the patients, the clinical symptoms in 38 cases （84.4%） were improved after standard anticoagulation/thrombolytic treatment, and one of them developed subcutaneous ecchymosis; four cases （8.9%） developed pulmonary embolism （PE） during anticoagulation/thrombolytic therapy, of whom 3 cases had their PE symptoms relieved after aggressive treatment, and 1 cases died despite lifesaving efforts; the symptoms of 3 cases （6.7%） with risk of bleeding were relieved only by immobilization, symptomatic treatments and blood circulation promoting drugs. In the 8 patients with peripherally inserted central venous catheter （PICC）-related upper extremity DVT, the catheters were removed after treatment according to individual situations, and no obvious PE symptoms were noted. Conclusion： Patients with malignant tumor have a higher risk of DVT and aggressive treatment should beinitiated as early as possible after the diagnosis of DVT in these patients. For patients with DVT without apparent predisposing cause should receive high vigilance for the possibility of to occult malignant tumor.

关 键 词：血栓形成 深静脉 肿瘤 血栓后综合征 肺栓塞 

分 类 号：R654.4[医药卫生—外科学]