肺癌合并静脉血栓栓塞症的风险评估

静脉血栓栓塞症(venous thromboembolism,VTE)是癌症常见的并发症和最常见的死亡原因之一,主要包括深静脉血栓栓塞症和肺血栓栓塞症.近年来,随着血栓栓塞性疾病研究的深入,肺癌相关性VTE已引起关注.其中,肺癌患者的预防性抗凝治疗具有很大争议性.初级预防能使肺癌相关性VTE发生风险减少,但相关研究同时提示患者出血风险提高.目前尚不推荐对肺癌患者进行常规抗凝,但对血栓风险高、出血风险低的肺癌患者进行选择性抗凝可使其获益.因此,肺癌相关性VTE的风险评估和分级可提高预防性抗凝的临床获益,减少相关出血事件.

Venous thrombosis risk assessment for patients with lung cancer

Venous thromboembolism is a common complication of cancer and the cause of death, which includes deep venous thrombosis and pulmonary embolism.In recent years,the relation between thromboembolic disease and lung cancer has attracted attention.Preventive anticoagulant therapy in patients with lung cancer is very controversial.The primary prevention can reduce the risk of venous thromboembolism,but increase the risk of bleeding.It is not recommended that routine anticoagulation for patients with lung cancer,except for patients with high risk of thrombosis and low risk of bleeding. Therefore,the risk assessment of venous thromboembolism for these patients can improve the clinical benefit of prophylactic anticoagulation.