恶性肿瘤并发深静脉血栓形成33例诊治分析

目的探讨恶性肿瘤患者合并静脉血栓形成(VTE)的影响因素，治疗及VTE对生存的影响。方法 回顾性分析本科近年收治 的33例合并VTE的恶性肿瘤患者临床资料，对栓塞部位，血小板，D-二聚体及纤维蛋白原水平及生存资料进行分析 。结果 1例肺栓塞患者4小时内死亡。其余32例患者中，痊愈11例，好转8例，无效14例。恶性肿瘤发生VTE时血浆 D-二聚体及纤维蛋白原水平明显高于正常值，且D-二聚体高水平患者的中位生存期(80天)远低于低水平的患者(420 天)，两者比较差异有统计学意义(P=0.026)。结论 恶性肿瘤患者并发VTE后严重影响生存，治疗主要采用抗凝，祛 聚集等。D-二聚体以及纤维蛋白原水平对于VTE诊断及预后有临床价值。

Clinical Study on 33 Cases of Malignant Tumor Complicated with Venous Thrombotic Embolism

Objective To assess the influencing factors,treatment and prognosis of malignant tumor patients with venous thomboembolic events(VIE).Methods The clinical data, including the site of thrombosis,platelet,D-dimer and fibrinogen level,of 33 patients with malignant tumor and VTE were retrospectively analyzed.Results One case complicated with pulmonary embolism(PTE) died within 4 h.Among the other 32 cases with deep venous thrombosis(DVT),11 cases obtained complete response,8 partial response,and 14 progress proceed.D-dimer and fibrinogen increased when VTE occurred.The median survival time of patients with high level D-dimer was 80 d which was lower than those patients with low levels(420 d).They showed significant difference(P=0.026).Conclusion The main treatments of anti-VTE are anticoagulation and anti-assembly.D-dimer,Fibrinogen in the diagnosis and prognosis determination of the patients with VTE are important prognostic factors.