恶性肿瘤围术期发生静脉血栓栓塞症患者的临床特征  

Clinical features of venous thrombosis in perioperative period in patients with malignant tumors

作　　者：李悦[1] 孙晓芳[1] 马宁 安云霞 马汝飞 刘晓丽[1] 王荣[1] 高岚 LI Yue;SUN Xiaofang;MA Ning;AN Yunxia;MA Rufei;LIU Xiaoli;WANG Rong;GAO Lan(Department of Laboratory Medicine,Henan University People's Hospital,Henan Provincial People's Hospital,Zhengzhou450003,China;Department of Oncology,Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Zhengzhou450003,China;Department of Pulmonary Medicine,Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Zhengzhou450003,China)

机构地区：[1]河南大学人民医院河南省人民医院检验科,郑州450003 [2]郑州大学人民医院河南省人民医院肿瘤内科,郑州450003 [3]郑州大学人民医院河南省人民医院呼吸内科,郑州450003

出　　处：《中华实用诊断与治疗杂志》2020年第3期286-288,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省卫生健康委员会省部共建项目(SB201901071)。

摘　　要：目的总结恶性肿瘤围术期发生静脉血栓栓塞症(venous thromboembolism,VTE)患者的临床特征。方法回顾性分析114例围术期发生VTE的恶性肿瘤患者的临床资料,其中发生肺血栓栓塞症(pulmonary thromboembolism,PTE)18例为PTE组,发生深静脉血栓形成(deep venous thrombosis,DVT)79例为DVT组,发生PTE+DVT 17例为PTE+DVT组。结果PTE组、PTE+DVT组呼吸系统肿瘤患者分别占50.0%、41.2%,DVT组消化系统肿瘤患者占41.8%。PTE组、PTE+DVT组、DVT组肿瘤TNM分期Ⅲ~Ⅳ期比率分别为88.9%、88.2%、73.4%,中低分化肿瘤比率分别为83.3%、88.2%、86.1%,3组比较差异无统计学意义(P>0.05)。PTE+DVT组活化部分凝血酶原时间[(43.67±9.76)s]较PTE组[(38.43±8.56)s]、DVT组[(36.25±6.63)s]延长(P<0.05),PTE组与DVT组比较差异无统计学意义(P>0.05);PTE+DVT组国际标准化比值(1.73±0.93)较DVT组(1.13±0.37)高,凝血酶原时间[(21.41±10.59)s]较DVT组[(14.61±4.52)s]延长(P<0.05),PTE组国际标准化比值、凝血酶原时间与PTE+DVT、DVT组比较差异无统计学意义(P>0.05);PTE组血浆纤维蛋白原[(5.02±2.45)g/L]较PTE+DVT组[(3.77±1.65)g/L]、DVT组[(3.93±1.54)g/L]升高(P<0.05),PTE+DVT组纤维蛋白原与DVT组差异无统计学意义(P>0.05)。结论恶性肿瘤患者围术期发生DVT和/或PTE多见于TNM分期高、分化程度低的消化系统和呼吸系统肿瘤患者,凝血功能检测可能有助于VTE类型的鉴别。Objective To summarize the clinical characteristics of venous thromboembolism(VTE)in patients with malignant tumors.Methods The clinical data of 114 cases of malignant tumors complicated with perioperative VTE were retrospectively analyzed,including 18 cases of pulmonary thromboembolism(PTE)(PTE group),79 cases of deep venous thrombosis(DVT)(DVT group),and 17 cases of PTE+DVT(PTE+DVT group).Results The respiratory system tumors accounted for 50.0%and 41.2%in PTE group and PTE+DVT group,and digestive system tumors accounted for 41.8%in VT group.The percentages of TNM stageⅢtoⅣ(88.9%,88.2%,73.4%)and moderately/poorly differentiated tumors(83.3%,88.2%,86.1%)showed no significant differences among PTE group,PTE+DVT group and DVT group(P>0.05).The activated partial prothrombin time was longer in PTE+DVT group((43.67±9.76)s)than that in PTE group((38.43±8.56)s)and DVT group((36.25±6.63)s)(P<0.05),and showed no significant difference between PTE group and DVT group(P>0.05).The international normalized ratio was higher in PTE+DVT group(1.73±0.93)than that in DVT group(1.13±0.37),and the prethrombin time was longer in PTE+DVT group((21.41±10.59)s)than that in DVT group((14.61±4.52)s)(P<0.05),while the international normalized ratio and the prethrombin time showed no significant differences in PTE group compared with those in PTE+DVT group and DVT group(P>0.05).The plasma fibrinogen was higher in PTE group((5.02±2.45)g/L)than that in PTE+DVT group((3.77±1.65)g/L)and DVT group((3.93±1.54)g/L)(P<0.05),and showed no significant difference between PTE+DVT group and DVT group(P>0.05).Conclusion DVT and PET in the perioperative period usually occur in patients with high clinical stage and poorly differentiated digestive system and respiratory system tumors,and the detection of coagulation function may be helpful for the identification of VTE types.

关 键 词：恶性肿瘤 静脉血栓栓塞症 深静脉血栓形成 肺血栓栓塞症 凝血功能 

分 类 号：R730.5[医药卫生—肿瘤]