摘要
目的探讨肿瘤合并肺栓塞患者的临床特点,为临床肿瘤合并肺栓塞早期预防和诊治提供依据。方法对我院2014年1月至2016年12月收治的肿瘤合并肺栓塞的患者临床资料进行回顾性分析。结果恶性肿瘤合并肺栓塞患者95例,平均年龄(62.7±11.8)岁,≥60岁56例,占58.9%,其中腺癌56例,合并下肢单纯深静脉血栓(DVT)49例,合并高血压48例,合并糖尿病有18例,合并高胆固醇血症14例,合并高尿酸血症12例。肺栓塞诊断在肿瘤诊断之前有18例,肺栓塞与肿瘤同时诊断30例,肺栓塞诊断在肿瘤诊断之后47例。30例接受化疗或靶向药物治疗间期发生肺栓塞,16例化疗方案含铂类药物。2例接受溶栓联合低分子肝素抗凝治疗,67例单独接受低分子肝素抗凝治疗,22例接受低分子肝素桥接华法林抗凝治疗,3例接受利伐沙班抗凝治疗。92例抗凝治疗后症状缓解,有效率96.8%。结论年龄≥60岁,病理类型为腺癌、合并DVT、恶性肿瘤诊断3个月内患者高发肺栓塞,恶性肿瘤合并肺栓塞患者的早期诊断、预防与治疗是降低病死率及改善预后的关键因素。
Objective To explore the clinical feature of malignant tumor accompanied with pulmonary embolism（PE）,which may provide the evidence for early prevention,diagnosis and treatment.Methods Clinical data of patients diagnozed with PE and tumor during from January 2014 to December 2016 were retrospectively analyzed.Results In 95 cases of tumor with PE,the average age was（62.7±11.8）years,56 cases（58.9%）were≥60 years,56 cases were with pathology of adenocarcinoma,49 cases were complicated with lower limb DVT,48 cases were complicated with hypertension,18 cases were complicated with diabetes,and 14 cases were complicated with hypercholesterolemia,and 12 cases were complicated with hyperuricemia,18 cases were diagnozed of PE before tumor,30 cases diagnozed PE and tumor simultaneously,47 cases diagnozed PE after tumor.30 cases suffered from PE during chemotherapy or targeted medication.The therapies were several combinations,as 16 cases received chemotherapy with platinum drugs,2 PE patients received thrombolytic therapy combined with low molecular weight heparin（LMWH）,67 cases LMWH maintenance anticoagulation therapy,22 cases LMWH bridging anticoagulation with warfarin therapy,3 patients anticoagulation therapy of rivaroxaban.92（96.8%）patients were relieved after anticoagulation therapy.Conclusion Age≥60 years,pathology of adenocarcinoma,combined DVT,with in 3 months after diagnosis of malignant tumor are at high risk of PE.Early diagnosis,prevention and treatment of patients with malignant tumor complicated with PE are key factors to reduce the mortality and improve the prognosis.
出处
《临床荟萃》
CAS
2017年第12期1041-1044,共4页
Clinical Focus
基金
国家自然科学基金青年项目(81603197)
关键词
肺栓塞
肿瘤
肝素
pulmonary embolism
tumor
heparin
