肿瘤合并肺栓塞研究进展

发布时间：2016-10-02 07:03

引言

肺血栓栓塞症（pulmonary thrombo embolism， PTE）是一种可以导致血栓阻塞部位远端的肺组织坏死的常见临床疾病，一般通过血流瘀滞、血管壁损伤和血液高凝状态为主要诱因，也被称为肺栓塞的基本要素。目前，经临床试验证明肿瘤患者死亡的重要因素之一，肿瘤患者在患癌阶段重要的并发症是肺血栓栓塞症[1]，该症发病率在临床试验中的统计结果为4%-20%，如何早期诊断、治疗和预防该癌症并发症，成为国内外临床研究和亟需解决的重要问题。
肿瘤相关性PTE对患者的生活产生较为严重的影响，患者需要较长时间进行抗凝治疗，经临床试验，肿瘤相关性PTE患者中12%有出血的并发症[10]，就是使用了抗凝治疗，，仍然有21%的患者复发；肿瘤相关性PTE患者需要延迟化疗，严重者必须要停止化疗；肿瘤相关性PTE患者，在放化疗治疗之外，还要额外占用医疗资源，这些不利后果，导致肿瘤相关性PTE患者的生活质量较低[11-14]；肿瘤患者死亡的第一位原因是肿瘤本身，第二原因就是肿瘤相关性PTE，并且该并发症是患者的短期及长期的治愈主要难题。
长期以来，多数国家认为肺血栓栓塞症不是常见病，在我国，更是认为肺血栓栓塞症并不常见，近年来，我国的医务工作者开始认识到该病症的严重性，尤其是呼吸和心血管疾病的大夫，在临床中经常遇到肺血栓栓塞症患者，他们的防治意识不断增强，同时，我国的专业人士开始从事专门的研究，并且在预防和治疗PTE方面取得了很大的进展[15]。肺血栓栓塞症被广泛认知的另一方面，是该病症与恶性肿瘤息息相关，肿瘤是肺血栓栓塞症的最危险的诱发因素，然而，经《2012中国肿瘤登记年报》统计，我国每分钟有6人被诊断为癌症，每年癌症死亡病例高达270万例，这个数据还在不断的被刷新[16]。癌症的高发率和高死亡率，让癌症并发症也成为人们关注的首要问题，经临床研究显示，恶性肿瘤患者中，PTE的发生率约为4%到20%[17]，并且肺血栓栓塞症是恶性肿瘤患者死亡的主要因素。

1肿瘤合并肺栓塞的临床表现
2 发病机制分析
3 危险因素分析
4 肿瘤患者合并PTE的诊断
5 肿瘤患者合并PTE的治疗
6 肿瘤患者PTE的预防

结语

通过最新的《2013年中国肿瘤登记年报》中披露，我国的癌症发现速度已经达到每分钟6人，癌症已经成为我国死亡病因中占据比例比较高的一种恶性疾病，肿瘤患者的主要并发症之一—PTE也是导致患者死亡的因素。在肿瘤患者合并PTE的研究中，大多对患者按照是否有转移进行划分，而对患者的TNM分级以及PS评分等方面的研究较少，而肿瘤患者的TNM分级和体力状态对合并PTE有着明显的关系。同时，由于患者化疗的治疗过程记录往往存在疏漏，造成对肿瘤合并PTE的量化分析带来一定的难度。为了更好地开展肿瘤合并PTE的预防，加强这方面的普及教育，需要从临床医生入手，详细分析肿瘤合并PTE的为危险因素、治疗方案以及预防方案，从而改善肿瘤患者的治疗条件。

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