低分子肝素治疗恶性肿瘤并发深静脉血栓剂量及疗效的初步研究(附27例分析)

目的探讨应用低分子肝素治疗恶性肿瘤合并深静脉血栓形成的剂量及效果,分析联合其他常规抗肿瘤治疗手段对生存期以及疗效有影响的相关因素。方法回顾性分析本院2007年1月至2011年1月收治的27例恶性肿瘤合并深静脉血栓患者的临床资料。抗凝治疗方法:每天低分子肝素0.1 U/kg皮下注射,体质量>60 kg者,每天低分子肝素0.6 mL皮下注射,体质量<60 kg者,每天低分子肝素0.3 mL皮下注射,中位治疗时间21天(0-180.0天)。结果 27例恶性肿瘤合并深静脉血栓患者应用低分子肝素抗凝治疗的短期疗效客观有效率66.7%,疾病控制率85.2%。不良反应少。中位生存期8.5月(0-33.2月)。根据患者体质量调整应用低分子肝素抗凝治疗相对安全,抗肿瘤治疗疗效与低分子肝素短期疗效相关(P=0.000)。结论恶性肿瘤患者合并血栓患者应用低分子肝素抗凝治疗安全,疗效较好,耐受性好,其抗肿瘤治疗疗效与低分子肝素治疗血栓短期疗效相关。

Clinical significance of low molecule heparin for treatment of cancer patients with deep venous embolism

Objective To explore the dose and the effect of low molecular heparin in the treatment of cancer patients with deep venous embolism,and to figure out the effect of concurrent administration with heparin combined with standard anti-cancer treatments.Methods The clinical data of 27 advanced stage cancer patients with symptoms of deep venous embolism from January 2007 to January 2011 were retrospectively analyzed.The administrative dosage of heparin was 0.1/kg subcutaneously daily which was given 0.3 mL for body weight less than 60 kg vesus 0.6 mL for those more than 60 kg.The mean duration of injection was 21 days（0-180 days）.Results The total response rate for those receiving heparin was 66.7%,disease control rate was 85.2%.There were fewer adverse reactions.The median survival time was 8.5 months（0-33.2 months）.Using heparin based on the weight of the patients was safe.The short-term effect of anticoagulant therapy and the effect of anti-tumor therapy were related（P=0.000）.Conclusions The treatment for the cancer patients with deep venous embolism with heparin is safe and tolerable.The short-term effect of anticoagulant therapy and the effect of anti-tumor therapy are related.