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目的:了解恶性淋巴瘤(malignant lymphoma,ML)患者并发静脉血栓栓塞(venous thromboembolism ,VTE )的临床特点及血液学指标变化情况,为预防和治疗ML合并VTE 提供有效依据。方法:回顾性分析2010年10月至2014年4 月江苏大学附属昆山医院收治的65例ML合并VTE 患者的临床资料,观察凝血功能和血液流变学等血栓相关血液学指标。结果:ML合并VTE 患者男女比例为2.6 1:1,主要集中于较晚期的患者,81.54% 病例为ⅢB~Ⅳ期。66.15%(43例)在ML确诊后发现。55例(84.62%)并发深静肿血栓形成(deep vein thrombosis,DVT ),7 例(10.77%)并发肺栓塞(pulmonary embolism,PE),仅3 例(4.62%)同时并发DVT和PE。上肢和颈部静脉为DVT 的最常见发生部位,占67.27%(37例)。 ML合并DVT 主要表现为患肢肿胀、胀痛和皮温升高,而PE患者表现为不明原因的呼吸困难、胸痛和晕厥。55例DVT 患者治疗总有效率为49.09%(27例),而PE患者仅为14.29%(1例)。 与单独ML患者相比,ML合并VTE 患者血小板聚集、D-dimer、血液高切黏度、低切黏度、血浆黏度、红细胞比容、红细胞聚集指数和刚性指数均明显升高,而APTT、血沉、变形指数和血平均流速明显降低。结论:ML合并VTE 多为DVT ,好发于男性,且集中于晚期患者,上肢和颈部静脉为好发部位,患者血液学指标向“易栓状态”变化。 相似文献
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目的:静脉血栓栓塞症(VTE)是恶性肿瘤患者常见并发症。本文结合文献分析我院住院病人宫颈癌患者静脉血栓的临床特征,分析VTE形成机制及诱发因素,探索最佳治疗方法。方法:对近5年我科收治的宫颈癌合并深静脉血栓30例患者的临床资料进行分析。结果:30例患者中17例VTE的发生和介入手术化疗有关。2例(6.7%)血栓栓塞发生在宫颈癌确诊之前,28例(93.3%)发生在宫颈癌确诊之后,单纯并发下肢深静脉血栓形成(DVT)27例,合并肺栓塞(PTE)2例,DVT合并PTE 1例。22例在栓塞前有化疗史。结论:血栓可能为肿瘤病人的首发表现,病人出现不能解释的血栓栓塞性疾病应考虑有肿瘤的可能。抗凝治疗对于血栓栓塞症疗效确切。及时诊断和治疗可以延长患者的生存期,降低患者的死亡率。口服避孕药、口服甲地孕酮、介入手术与VTE的发生几率可能有关。分期晚,远地转移的肿瘤患者易出现血栓栓塞。 相似文献
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静脉血栓栓塞症(venous thromboembolism,VTE)在癌症患者中发病率较高,是导致癌症患者疾病进展或死亡的重要因素。下肢深静脉血栓(deep vein thrombosis,DVT)形成在VTE中占比多、危害大,可分为近端DVT形成(proximal deep vein thrombosis,PDVT)及孤立性下肢远端DVT形成(isolated distal deep vein thrombosis,IDDVT)。PDVT的风险评估及管理策略已有较多研究,然而对约占下肢DVT 50%的IDDVT却鲜有研究,临床工作中对癌症相关性IDDVT的风险评估及管理策略也欠规范,因此本文对癌症相关性孤立下肢远端深静脉血栓形成的临床研究进行综述。 相似文献
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Julia HOY Teresa NEEMAN Robin STUART-HARRIS Alison DAVIS 《Asia-Pacific Journal of Clinical Oncology》2009,5(2):129-136
Aim: Previous studies have shown that adjuvant chemotherapy in early breast cancer (EBC) may increase the risk of venous thromboembolism (VTE). Clinical experience suggests the combination of 5-fluorouracil, epirubicin and cyclophosphamide (FEC) may be associated with a higher frequency of VTE than other regimens. This study aims to investigate the use of adjuvant FEC compared with other adjuvant regimens in the development of VTE in patients with EBC.
Methods: A retrospective audit was conducted examining all eligible patients who received adjuvant chemotherapy for EBC in the Australian Capital Territory from 1 January 2005 to 30 June 2007. Data were collected from patients' notes, including risk factors for VTE, tumor pathology, chemotherapy details and incidence of VTE. Comparisons using χ2 tests and independent samples t -tests were made between patients who received FEC and those who received another regimen. Multivariate logistic regression was used to investigate prognostic factors for the development of VTE.
Results: A total of 325 patients were included in the study, of whom 176 received FEC and 149 received other adjuvant chemotherapy regimens. The incidence of VTE in patients who received FEC was 47/176 (27%), which was significantly higher than for patients who received other regimens (7/149, 5%, P < 0.001). FEC was the only significant prognostic factor for the development of VTE (OR 7.9, 95% CI 3.3–19.2, P < 0.001).
Conclusion: The use of adjuvant FEC chemotherapy is associated with an increased incidence of VTE in patients with EBC compared with other commonly used chemotherapy regimens. 相似文献
Methods: A retrospective audit was conducted examining all eligible patients who received adjuvant chemotherapy for EBC in the Australian Capital Territory from 1 January 2005 to 30 June 2007. Data were collected from patients' notes, including risk factors for VTE, tumor pathology, chemotherapy details and incidence of VTE. Comparisons using χ
Results: A total of 325 patients were included in the study, of whom 176 received FEC and 149 received other adjuvant chemotherapy regimens. The incidence of VTE in patients who received FEC was 47/176 (27%), which was significantly higher than for patients who received other regimens (7/149, 5%, P < 0.001). FEC was the only significant prognostic factor for the development of VTE (OR 7.9, 95% CI 3.3–19.2, P < 0.001).
Conclusion: The use of adjuvant FEC chemotherapy is associated with an increased incidence of VTE in patients with EBC compared with other commonly used chemotherapy regimens. 相似文献
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A. J. Muñoz Martín P. García Alfonso A. B. Rupérez Blanco S. Pérez Ramírez M. Blanco Codesido M. Martín Jiménez 《Clinical & translational oncology》2014,16(10):927-930
Purpose
To evaluate the incidence of venous thromboembolism (VTE) in ambulatory pancreas cancer patients receiving chemotherapy and analyze Khorana’s predictive model of chemotherapy-associated thrombosis.Methods/patients
We performed a retrospective review to determine the incidence of VTE in the gastrointestinal cancer unit of our center. Between 2008 and 2011, 84 consecutives patients diagnosed with pancreas adenocarcinoma were identified and included in the analysis. Pancreatic neuroendocrine tumors were excluded.Results
Thirty patients experienced VTE (35.7 %) and 66 % of the events were diagnosed during the first 6 months after diagnosis. Khorana’s score: 33.3 % of the intermediate category patients developed a venous thromboembolic event and 37.5 % in the high-risk category.Conclusions
The high incidence of VTE observed in this study is consistent with prior reports. Specific predictive model for chemotherapy-associated thrombosis in pancreatic cancer must be investigated. 相似文献15.
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