日间治疗模式下恶性肿瘤合并静脉血栓栓塞患者临床特点与管理情况回顾性研究  

Clinical characteristics and management of patients with malignant tumor complicated with venous thromboembolism in outpatient setting

作　　者：郑艳群[1] 王闫飞 王丹[2] 张红[1] 李秋钰 刘钟芬 刘巍[1,4] 薛冬[2,5] Zheng Yanqun;Wang Yanfei;Wang Dan;Zhang Hong;Li Qiuyu;Liu Zhongfen;Liu Wei;Xue Dong(Day Oncology Unit,Key Laboratory of Malignant Tumor Pathogenesis and Transformation Research,Ministry of Education,Peking University Cancer Hospital and Beijing Cancer Institute,Beijing 100142,China;Medical Department,Key Laboratory of Malignant Tumor Pathogenesis and Transformation Research,Ministry of Education,Peking University Cancer Hospital and Beijing Cancer Institute,Beijing 100142,China;Department of Respiratory Medicine,Peking University Third Hospital,Beijing 100191,China;Department of Supportive Care,Key Laboratory of Malignant Tumor Pathogenesis and Transformation Research,Ministry of Education,Peking University Cancer Hospital and Beijing Cancer Institute,Beijing 100142,China;Department of Integrated Traditional Chinese and Western Medicine,Key Laboratory of Malignant Tumor Pathogenesis and Transformation Research,Ministry of Education,Peking University Cancer Hospital and Beijing Cancer Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所日间化疗病区恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所医务处恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [3]北京大学第三医院呼吸内科,北京100191 [4]北京大学肿瘤医院暨北京市肿瘤防治研究所支持治疗科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [5]北京大学肿瘤医院暨北京市肿瘤防治研究所中西医结合科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《肿瘤综合治疗电子杂志》2022年第3期85-92,共8页Journal of Multidisciplinary Cancer Management(Electronic Version)

基　　金：北京市医院管理中心培育计划(PG2020023);北京市医院管理局“使命”计划专项经费(SML20181102);中华人民共和国人力资源和社会保障部百千万工程领军人才万人计划资助;北京大学肿瘤医院科学研究基金(2021-23)。

摘　　要：目的了解日间治疗模式下恶性肿瘤合并静脉血栓栓塞(venous thromboembolism,VTE)患者的临床特征及管理情况,为医院管理日间肿瘤合并VTE患者提供参考依据。方法回顾性分析2013年1月至2019年12月就诊于北京大学肿瘤医院的170例恶性肿瘤合并VTE患者的临床资料。结果170例患者中男女患者人数比例为1.93∶1,中位年龄59.0(54.0~65.0)岁。患者主要来源于北京(32.95%)及其周边华北、东北地区。原发肿瘤前4位为消化道肿瘤67例(39.4%)、肺癌53例(31.2%)、淋巴瘤23例(13.5%)及乳腺癌12例(7.1%)。患者确诊VTE的时间在肿瘤确诊后中位时间55(16.5~221.5)d,98例(57.6%)患者VTE确诊于肿瘤确诊后半年内。VTE患者中肺栓塞患者22例(12.6%),深静脉血栓患者155例(91.2%),浅静脉血栓患者1例(0.6%)。应用Caprini评分、Padua评分、Khorana评分对患者进行回顾性VTE风险评估,中高危患者分别占96.5%、18.2%与30.0%,提示现有评分工具对于预测日间肿瘤患者VTE风险存在不足。结论VTE是恶性肿瘤的常见并发症之一,恶性肿瘤的VTE规范防治应引起肿瘤医生的重视。Objective To evaluate the characteristics and management of patients with malignant tumor complicated with venous thromboembolism(VTE)in outpatient setting,so as to provide reference for hospital management of patients with malignancy complicated with VTE.Method The clinical data of 170 patients with malignant tumor complicated with VTE treated in Beijing Cancer Hospital Day Oncology Unit from January 2013 to December 2019 were collected and analyzed retrospectively.Result Among the 170 patients,the ratio of male to female patients was 1.93:1,with the median age of 59.0(interquartile range 54.0 to 65.0).The patients mainly came from Beijing(32.95%)and its surrounding province in North China and Northeast China.The top 4 tumors were digestive tract tumors in 67 cases(39.4%),lung cancer in 53 cases(31.2%),lymphoma in 23 cases(13.5%),and breast cancer in 12 cases(7.1%).The median time of VTE diagnosis after tumor diagnosis was 55(16.5 to 221.5)days.98(57.6%)cases of patients were diagnosed with VTE within half a year after tumor diagnosis.Among the VTE patients,there were 22(16.2%)patients with pulmonary embolism,155(91.2%)cases of patients with deep venous thrombosis and 1(0.6%)case of patient with superficial venous thrombosis.Using Caprini score,Padua score and Khorana score to retrospectively evaluate the VTE risk,patients with medium to high risk taken up 96.5%,18.2%and 30.0%respectively,indicating poor sensitivity of Padua score and Khorana score.Conclusion VTE is one of the common complications of malignant tumors,and the standardized prevention and treatment of VTE in malignant tumors should be noticed by oncologists.

关 键 词：日间 肿瘤 静脉血栓栓塞 深静脉血栓 肺栓塞 

分 类 号：R730[医药卫生—肿瘤] R543.6[医药卫生—临床医学]