预防恶性肿瘤患者静脉血栓栓塞症的临床分析  

Clinical analysis of venous thromboembolism prevention for patients with malignant tumor

作　　者：王莉[1] 刘义[1] 高芸菲[1] 孔曼[1] 孔斌[1] 杨建东[1] 黄希芬[1] 裴文仲[1] 

机构地区：[1]首都医科大学潞河教学医院肿瘤科,北京101149

出　　处：《实用临床医药杂志》2013年第7期118-120,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11320044)

摘　　要：目的探讨预防恶性肿瘤患者静脉血栓栓塞症的临床方法。方法将80例恶性肿瘤住院患者随机分为干预组60例和对照组20例。干预组根据血栓弹力图及凝血检查结果进行相应干预;对照组不予干预。干预组再根据不同高凝因素分为深静脉血栓(DVT)形成组(A组)、红细胞聚集组(B组)、无血栓及红细胞聚集组(C组),每组20例。观察各组患者下肢DVT形成、肺血栓栓塞症(PTE)以及出血事件发生情况。结果住院期间,干预组DVT发生率、致死性PTE发生率均显著低于对照组。各组住院期间以及出院随访期间出血事件比较,差异均无统计学意义。结论对于恶性肿瘤患者,根据血栓弹力图及凝血提示了解血栓形成早期凝血改变,并实施积极干预,可有效降低DVT及PTE发生率。根据不同致高凝状态,寻找不同因素,采取个体化治疗,可确保治疗的有效性及安全性。Objective To investigate the clinical methods of venous thromboembolism （VTE） prevention for patients with malignant tumor. Methods Eighty hospitalized patients with malignant tumor were randomly divided into intervention group （ n = 60） and control group （ n = 20）. The intervention group was intervened whereas the control group was not intervened. according to thrombelastogram and clotting results, According to different hypercoagulable factors, inter- vention group was further grouped into deep venous thrombosis （DVT） group （group A）, erythro- cyte aggregation group （group B） and erythrocyte aggregation group without thrombosis （group C）, 20 cases in each. group. DVT in lower limbs, pulmonary thromboembolism （PTE） and occur- rence of hemorrhagic events of patients in each group were observed. Results During hospitaliza- tion, both incidences of DVT and fatal PTE in the intervention group were significantly lower than those in the control group. Compared with hemorrhagic events in each group during hospitalization and follow- up visit, all the differences showed no statistical significance. Conclusion For patients with malignant tumor, understanding early clotting changes of thrombosis according to thrombelas- togram and clotting presentation and taking positive interventions can effectively reduce the inci- dence rates of DVT and PTE. Seeking different causal factors based on different hypereoagulable states and applying individual treatment can ensure the efficiency and safety of treatment.

关 键 词：恶性肿瘤 血栓弹力图 高凝状态 血栓形成 

分 类 号：R730.6[医药卫生—肿瘤]