结直肠癌合并肺血栓栓塞症16例疗效分析

目的提高对结直肠癌合并肺血栓栓塞症(PTE)临床特点的认识。方法对16例结直肠癌合并PTE患者的一般情况、临床表现以及疗效等临床资料进行回顾性分析。结果 16例患者男性占75.00%(12例),女性25.00%(4例);年龄主要集中在60岁以上,占62.50%;结直肠癌分期均为进展期,其中Ⅳ期占75.00%(12例),Ⅲ期占25.00%(4例);且多发于已经进行化疗的患者,占81.25%(13例)。16例患者,死亡1例,其余15例均好转出院,治疗有效率为93.75%;其中,4例大面积PTE实行溶栓治疗的患者均出现出血现象,出血并发症发生率为25%。结论本研究初步表明结直肠癌并发的PTE可能具有好发于肿瘤进展期的老年男性患者的特征,并发症的发生可能与化疗有关;建议对结直肠癌患者进行定期检查血液黏稠度及血脂水平,尽量降低肿瘤患者血液高凝状态,去除导致血栓形成病因;建议溶栓治疗时减少尿激酶的用量。

Ciinicaleffect of 16 cases with colorectal cancer combined with pulmonary thromboembolism

Objective To improves clinical awareness of colorectal cancer with pulmonary thromboembolism. Methods Retrospectively analysize the general condition, clinical manifestations and efficacy of colorectal cancer combined the PTE in 16 cases. Results All 16 cases of colorectal cancer combined the PTE patients, males accounted for 75.00% （12 cases） , 25.00% for females （4 cases） ;The morbidity age mainly concentrates above 60 years old peoples, accounts for 62. 50%; All colorectal cancer staging are advanced, including 75% of stage Ⅳ （12 cases）, and stage Ⅲ 25% （4 cases） ; Most appear in the patients who already underwent chemotherapy, accounted for 81.25% （13 examples）. Gender and stage were difference of statistical significance （all P 〈0.05）. All 16 cases of patients, 1 case died, other 15 cases were discharged , the treatment effectiveness is 93.75% ; And, the 4 patients with large area PTE undergoing uro- kinase treatment suffered the hemorrhage, the incidence of hemorrhage is 25%. Conclusion Colorectal cancer concurrent PTE may prefer to occur in the old age male patient with tumor during progressive stage, and is related with the chemotherapy; Regularly check blood viscosity and lipid levels of colorectal cancer, to minimize tumor patients hypercoagulability, remove the cause of thrombosis etiology; Thrombolytic therapy is recommended to reduce the amount of urokinase.