以静脉血栓为首发表现的恶性肿瘤9例临床回顾

目的提高对以静脉血栓为首发表现的恶性肿瘤的认识水平。方法对我院2001—2010年住院患者中确诊的恶性肿瘤合并深静脉血栓的病例进行回顾性分析。结果10年期间共收治38例恶性肿瘤合并静脉血栓形成患者，其中9例（23．7％）患者以静脉血栓为首发临床表现，静脉血栓是在恶性肿瘤确诊前1周-6月被发现。4例患者表现为单纯下肢深静脉血栓形成，2例表现为单纯肺栓塞，2例表现为肺栓塞合并下肢深静脉血栓形成，1例表现为单纯右上肢深静脉血栓形成。结论静脉血栓栓塞性疾病可能是潜在恶性肿瘤的信号。对不明原因的深静脉血栓形成应考虑恶性肿瘤的可能，并进一步进行相关检查，尽早排查恶性肿瘤性疾病。

Clinical analysis of 9 cases of malignancy initially manifested with venous thromboembolism

Objective To increase the awareness of malignancy initially manifested with venous thromboembolism. Methods Cases of malignancy complicated with venous thromboembolism from January 2001 to December 2010 in Beijing Army General Hospital were retrospectively reviewed. Results A total of 38 cases of malignancy complicated with venous thromboembolism were retrieved during ten years. Of 38 cases, nine （23.7%）were initially manifested with venous thromboembolism, and venous thromboembolism was diag- nosed 1 week to 6 months ahead of malignancy. Of 9 cases,4 were pure deep venous thrombosis（DVT） of lower limb,2 were pulmonary thromboembolism（PIE） ,2 were DVT and PTE, and one was DVT of right upper extremity. Conclusion Venous thromboembolism could be a potential sign indicating occult malignancy. Physicians should be alert to malignancy for patients with venous thromboembo- lism under unknown origin, and the patients should be further examined to investigate the malignancy.