恶性肿瘤合并静脉血栓栓塞症21例临床分析

目的探讨恶性肿瘤合并静脉血栓栓塞症（VTE）高危因素、诊断、治疗以及预防。方法回顾性分析21例恶性肿瘤合并静脉血栓栓塞症的临床资料。结果 21例病例中1例深静脉血栓形成（DVT）患者因为活动性咯血而未进行抗凝治疗,随诊发现患者患肢肿胀加重,超声复查提示血栓较前增大。1例肺血栓栓塞症（PTE）患者因病情危重未来得及行抗凝治疗以及溶栓治疗已经死亡。另1例PTE患者经对症治疗病情稳定后接受低分子肝素、华法林抗凝治疗,复查超声提示静脉血栓较前缩小。其余18例DVT患者经过抗凝治疗后患肢肿胀,疼痛减轻、消失或（和）超声检查提示静脉血栓较前缩小、消失,血流恢复通畅。结论通过分析恶性肿瘤合并静脉血栓栓塞症高危因素、诊断、治疗以及预防,提高DVT诊疗水平,减少PTE的发生,对防治VTE有重要意义。

Clinical analysis of 21 patients of malignant tumor complicated with venous thrombotic embolism

Objective To assess the risk factors,diagnosis,treatment and prevention of venous thrombotic embolism（VTE） in patients with malignant tumor.Methods The clinical data of 21 patients with malignant tumor and VTE were retrospectively analyzed.Results Among total 21 cases 18 were managed with low molecular heparin and warfarin;after treatment the swelling and pain of the affected extremity were alleviated or disappeared,the venous thrombosis became smaller or disappeared,the blood flow became unobstructed.One patient in the group was not treated with anticoagulant due to active emptysis,the affected extremity became more swelling and the thrombosis was larger as presented by ultrasonography.One patient died from pulmonary thrombotic embolism before the anticoagulant therapy and thrombolysis.The other patients were treated by anticoagulant when the disease was stable after heteropathy,the thrombosis became smaller as shown on ultrasonography.Conclusion The risk factors,diagnosis,treatment and prevention of VTE in patients with malignant tumor are discussed in the paper and it suggests the importance to prevent or reduce the incidence of PTE and VTE in cancer patients.