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预防恶性肿瘤患者静脉血栓栓塞症的临床分析
引用本文:王莉,刘义,高芸菲,孔曼,孔斌,杨建东,黄希芬,裴文仲.预防恶性肿瘤患者静脉血栓栓塞症的临床分析[J].实用临床医药杂志,2013,17(7):118-120.
作者姓名:王莉  刘义  高芸菲  孔曼  孔斌  杨建东  黄希芬  裴文仲
作者单位:首都医科大学潞河教学医院肿瘤科,北京,101149
基金项目:中国高校医学期刊临床专项资金
摘    要:目的探讨预防恶性肿瘤患者静脉血栓栓塞症的临床方法。方法将80例恶性肿瘤住院患者随机分为干预组60例和对照组20例。干预组根据血栓弹力图及凝血检查结果进行相应干预;对照组不予干预。干预组再根据不同高凝因素分为深静脉血栓(DVT)形成组(A组)、红细胞聚集组(B组)、无血栓及红细胞聚集组(C组),每组20例。观察各组患者下肢DVT形成、肺血栓栓塞症(PTE)以及出血事件发生情况。结果住院期间,干预组DVT发生率、致死性PTE发生率均显著低于对照组。各组住院期间以及出院随访期间出血事件比较,差异均无统计学意义。结论对于恶性肿瘤患者,根据血栓弹力图及凝血提示了解血栓形成早期凝血改变,并实施积极干预,可有效降低DVT及PTE发生率。根据不同致高凝状态,寻找不同因素,采取个体化治疗,可确保治疗的有效性及安全性。

关 键 词:恶性肿瘤  血栓弹力图  高凝状态  血栓形成

Clinical analysis of venous thromboembolism prevention for patients with malignant tumor
WANG Li,LIU Yi,GAO Yunfei,KONG Man,KONG Bin,YANG Jiandong,HUANG Xifen,PEI Wenzhong.Clinical analysis of venous thromboembolism prevention for patients with malignant tumor[J].Journal of Clinical Medicine in Practice,2013,17(7):118-120.
Authors:WANG Li  LIU Yi  GAO Yunfei  KONG Man  KONG Bin  YANG Jiandong  HUANG Xifen  PEI Wenzhong
Institution:(Luhe Teaching Hospital Affiliated to Capital Medical University,Beijing,101149)
Abstract:Objective To investigate the clinical methods of venous thromboembolism(VTE) prevention for patients with malignant tumor.Methods Eighty hospitalized patients with malignant tumor were randomly divided into intervention group(n=60) and control group(n=20).The intervention group was intervened according to thrombelastogram and clotting results,whereas the control group was not intervened.According to different hypercoagulable factors,intervention group was further grouped into deep venous thrombosis(DVT) group(group A),erythrocyte aggregation group(group B) and erythrocyte aggregation group without thrombosis(group C),20 cases in each group.DVT in lower limbs,pulmonary thromboembolism(PTE) and occurrence of hemorrhagic events of patients in each group were observed.Results During hospitalization,both incidences of DVT and fatal PTE in the intervention group were significantly lower than those in the control group.Compared with hemorrhagic events in each group during hospitalization and follow-up visit,all the differences showed no statistical significance.Conclusion For patients with malignant tumor,understanding early clotting changes of thrombosis according to thrombelastogram and clotting presentation and taking positive interventions can effectively reduce the incidence rates of DVT and PTE.Seeking different causal factors based on different hypercoagulable states and applying individual treatment can ensure the efficiency and safety of treatment.
Keywords:malignant tumor  thrombelastogram  hypercoagulable states  thrombosis
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