摘要
目的分析肺癌合并血栓栓塞性疾病的临床特征,探讨其发病机制及早期预防和诊治的方法。方法对我院近6年由病理学或细胞学确诊的1 859例肺癌中23例肺癌合并血栓栓塞性疾病的病例进行回顾性分析。结果本组23例中腺癌20例。肺癌单纯并发下肢深静脉血栓形成11例(47.8%),并发肺栓塞12例(52.2%),其中6例同时有深静脉血栓形成。本组3例(13.0%)血栓栓塞发生在肺癌确诊之前,20例(87.0%)发生在肺癌确诊之后,其中17例(73.9%)肺癌确诊分布于栓塞前后150天内。23例中有20例血D-二聚体超过500μg/L,9例栓塞发生在化疗后。仅有1例心电图有明显SⅠQⅢTⅢ者表现。结论血栓栓塞性疾病常并发于肺癌,且以腺癌最多见,如不明原因在既往健康者中发生,应警惕有肺癌等恶性肿瘤的可能。肺癌并发血栓栓塞性疾病的主要原因是血液高凝状态,而化疗可成为促发因素。
Objective To analyze the clinical characteristics of lung cancer complicated by thromboembolic disease（TD） ,and approach its pathogenesy and the ways of diagnostic and treatment in the earlier period. Methods Twenty＇three cases of lung cancer with TD from i 859 cases of lung cancer confirmed by pathology and cytology in recent 6 years from the hospital were retrospectively reviewed. Results The pathology of 20 cases of lung cancer with TD was adenocarcinoma in the group. There were 11 cases（47.8%） only complicated by deep venous thrombosis （DVT）, 12 cases（52.2 %） complicated by pulmonary thromboembolism（PTE） in which there were 6 cases complicated by DVT and PE at the same time. 3 cases（13.0% ） of DVT/PTE occurred before detection of lung cancer. 20 cases （87.0%） of DVT/PTE occurred after detection of lung cancer. TD occurred in 17 cases （73.9%） around 150 days when the cases were confirmed with lung cancer. The D-dimer in plasma of 20 cases exceeded 500μg/L. There was only one case with typical sign of SⅠQⅢTⅢ of ECG in the group. There were 9 cases with the history of chemotherapy before TD were confirmed. Conclusion Lung cancer is often complicated by TD. The most common physiologic type of lung cancer complicating TD is adenocarcinoma. Physicians ought to be alert to lung cancer or other carcinoma when facing aged healthy subjects of sudden TD under unknown origin. Hypercoagulation state is the most important reason of TD complicating lung cancer. Chemotherapy may be the precipitating factor.
出处
《临床荟萃》
CAS
2010年第10期851-853,共3页
Clinical Focus
关键词
肺肿瘤
栓塞和血栓形成
病理状态
体征和症状
lung neoplasms
embolism and thromboembosis
pathological conditlons, signs and symptoms
