恶性肿瘤并静脉血栓栓塞症危险因素临床研究

发布时间：2018-06-15 07:24

本文选题：恶性肿瘤 + 静脉血栓栓塞症　；参考：《石河子大学》2017年硕士论文

【摘要】：目的探讨恶性肿瘤并静脉血栓栓塞症患者的相关危险因素。方法收集2015年11月-2016年9月在新疆自治区人民医院住院患者病例资料及血样标本79例,包括17例确诊恶性肿瘤并静脉血栓栓塞症患者(合并组),同期31例确诊单纯恶性肿瘤患者(单纯肿瘤组)及31例确诊单纯静脉血栓栓塞症患者(单纯栓塞组)。血样标本通过双抗体一步夹心法酶联免疫吸附试验(ELISA)检测血清因子含量。结果恶性肿瘤合并静脉血栓栓塞症多发生于高龄、肥胖、肿瘤中晚期、近期术后制动的患者。合并组患者以肺部恶性肿瘤合并静脉血栓栓塞症多见,其病理类型以腺癌为主,其次为消化系统、血液系统、泌尿生殖系统。合并组与对照组中肺癌和/或肺栓塞患者的主要临床症状以呼吸困难、胸闷、胸痛最多见,体征以呼吸急促最多见,两组无统计学差异(P0.05)。合并组与单纯肿瘤组比较,ADAMTS-13、TT值减低,vWF、D-D、FIB值升高,有显著统计学差异(P0.001)。合并组与单纯栓塞组上述指标比较,差异无统计学意义(P0.05)。接受正规治疗的患者,合并组好转8例,无效5例,死亡4例,单纯栓塞组好转25例,无效4例,死亡2例。合并组无效或死亡的比例明显高于单纯栓塞组(P0.05)。结论高龄、肥胖、肿瘤中晚期、近期术后制动的恶性肿瘤患者更易发生静脉血栓栓塞症。肺癌患者并发肺栓塞多见,呼吸困难、胸闷、胸痛及呼吸急促可提示我们肺栓塞发病可能。ADAMTS-13、vWF、D-D、FIB可能均具备独立预测静脉血栓栓塞风险的意义。恶性肿瘤合并静脉栓塞症预后较差,我们应对静脉栓塞高危人群进行早期干预与治疗。
[Abstract]:Objective to investigate the risk factors of malignant tumor complicated with venous thromboembolism. Methods from November 2015 to September 2016, 79 inpatients and blood samples were collected in Xinjiang Autonomous region people's Hospital. There were 17 patients with malignant tumor complicated with venous thromboembolism (combined group), 31 patients with simple malignant tumor (simple tumor group) and 31 patients with simple venous thromboembolism (simple embolism group). Serum factor levels were determined by double antibody one-step sandwich enzyme linked immunosorbent assay (Elisa). Results malignant tumor complicated with venous thromboembolism mostly occurred in the elderly, obesity, middle and late stage of tumor, and immobilization in the near future. In the combined group, pulmonary malignancy with venous thromboembolism was more common, and adenocarcinoma was the main pathological type, followed by digestive system, blood system and genitourinary system. The main clinical symptoms of patients with lung cancer and / or pulmonary embolism in the combined group and the control group were dyspnea, chest tightness, chest pain and signs of shortness of breath. There was no significant difference between the two groups (P 0.05). Compared with the simple tumor group, the ADAMTS-13 TT value in the combined group was significantly lower than that in the simple tumor group, and the FIB value was significantly higher than that in the control group (P 0.001). There was no significant difference in the above indexes between the combined group and the simple embolization group (P 0.05). There were 8 cases of improvement, 5 cases of ineffectiveness, 4 cases of death in the combined group, 25 cases of improvement, 4 cases of failure and 2 cases of death in the simple embolization group. The rate of failure or death in the combined group was significantly higher than that in the simple embolization group (P 0.05). Conclusion Venous thromboembolism is more common in patients with advanced age, obesity, advanced tumor and immobilization after operation. Pulmonary embolism is common in lung cancer patients. Dyspnea, chest tightness, chest pain and shortness of breath may indicate that the risk of pulmonary embolism may be independently predicted by ADAMTS-13vWFFFD-DIB. The prognosis of malignant tumor complicated with venous embolism is poor. We should carry out early intervention and treatment for high risk group of venous embolism.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R730.5

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