177例恶性肿瘤患者预防性抗凝治疗的疗效分析  

Therapeutic efficacy of prophylactic anticoagulation therapy in 177 patients with malignant tumors

作　　者：蔡夏水 刘芯[1] 张还珠[1] Cai Xiashui;Liu Xin;Zhang Huanzhu(Department of Oncology,First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属第一医院肿瘤内科,广东广州510120

出　　处：《广州医科大学学报》2022年第1期75-79,共5页Academic Journal of Guangzhou Medical University

摘　　要：目的:探讨预防性抗凝治疗对恶性肿瘤患者在化疗期间对凝血功能的影响、血栓发生情况及安全性的分析。方法:采用回顾性分析,将177例初治的Ⅲ-Ⅳ期恶性肿瘤患者分为抗凝组和非抗凝组,抗凝组为化疗+低分子肝素0.3 ml,qd,非抗凝组为单纯化疗。分析患者凝血指标、血栓发生的情况及出血不良事件。结果:预防性抗凝组,化疗后D-二聚体为1554.44±1591.70 ng/mL,较化疗前明显下降;而非抗凝组较化疗前明显升高,差异有统计学意义;血栓发生率预防性抗凝组4.1%,非抗凝组8.8%,差异无统计学意义,血栓发生距离确诊恶性肿瘤<12个月、>12个月的例数分别为9和2。抗凝组所有患者均未发现出血事件。结论:预防性抗凝治疗对恶性肿瘤患者改善高凝状态有一定积极作用,肿瘤患者合并血栓大部分发生在确诊1年内。Objective:To investigate the effect of prophylactic anticoagulation therapy in relation to the coagulation function,occurrence of thrombosis and safety profiles in patients with malignant tumors during chemotherapy.Methods:In this retrospective study,177 treatment-naive patients with stages III-IV malignant tumors were assigned to the anticoagulation and non-anticoagulation groups.The anticoagulation group was given chemotherapy plus low-molecular-weight heparin(0.3 ml once daily),while the non-anticoagulation group received chemotherapy alone.The coagulation indexes,occurrence of thrombosis and bleeding adverse events were recorded for the patients.Results:After chemotherapy,the D-dimer level was 1554.44±1591.70 ng/ml in patients given prophylactic anticoagulation,which was significantly decreased from baseline;and that in the nonanticoagulation group was significantly higher than baseline,with statistically significant difference.The incidence of thrombosis was comparable between the anticoagulation group(4.1%)and the non-anticoagulation group(8.8%).Thrombosis occurred within 12 months in 9 patients,and beyond 12 months in 2 others,of diagnosis of malignant tumor,respectively.No bleeding events were noted in all patients in the anticoagulation group.Conclusion:Prophylactic anticoagulation therapy is conducive to the improvement of hypercoagulable state in patients with malignancy.In most of the tumor patients,complication with thrombosis occurs within one year of diagnosis.

关 键 词：恶性肿瘤 静脉血栓 凝血功能 预防性抗凝 

分 类 号：R73[医药卫生—肿瘤]