Malignant Tumor With Pulmonary Thromboembolism Clinical Analysis Of 30 Cases

Objective:Pulmonary thromboembolism (pulmonary thromboembo-lism, PTE) is a common complication of malignant tumors. As early as 1865, Armand Trousseau reported on the relevance of tumor and thrombosis. In recent years, statistics show that in clinical cancer complicated by the incidence of thrombosis is 1%-11%.Thrombosis so that the condition of patients with malignant tumors and treatment of more complicated, not only increase the difficulty of treatment, and affect people s quality of life and prognosis, and therefore the relationship between cancer and thrombosis is increasingly subject to attention. In this paper, retrospective analysis of malignant tumor with pulmonary thromboembolism clinical data of 30 cases, concluding a special type of pulmonary embolism-tumor characteristics of pulmonary embolism, discuss of malignant tumor complicated with pulmo-nary embolism in the general clinical features, risk factors, laboratory findings, diagnosis, treatment and prognosis.Clinical Data Research Methods:Retrospective analysis of the First Affiliated Hospital of Dalian Medical University,5-year period(2005-2009) 30 cases of malignant tumors(mainly lung and gastrointestinal tumors) with pulmonary thromboembolism in patients with clinical data, and to collect the same period 30 cases of pulmonary embolism is not associated with malignant tumors in patients with such information as the control, the collection of acute symptomatic pulmonary thromboembolism in patients with sex, age and other clinical data in general; Chronic obstructive pulmonary disease, coronary heart disease, diabetes, hypertension, heart failure, recent braking history, history of recent surgery, History of varicose veins and other risk factors. as well as the coagulation, blood routine, blood gas analysis and Computed tomography pulmonary angio-graphy (Computed tomography pulmonary angiography, CTPA)and other indexes. SPSS17.0 software was used, Measurement data using T tests testing method, count data using X2 test. P<0.05 statistically significant.Results:A total of 30 patients in case group (mainly gastrointestinal and lung cancer), of which 17 cases of adenocarcinoma (74%), squamous cell carcinoma in 4 cases (17%), bile duct carcinoma in 1 case (3%), acinar cell carcinoma 1 case (3%), Tumor types in the highest percentage of adenocarcinoma, consistent with reports. Case group and control group, age, gender was not significant (P values were 0.375 and 0.29). Case group and control group PTE types to mainly non-massive pulmonary embolism were 24 cases (80%) and 21 patients (70%), different types of PTE in the two groups no significant difference (P=0.15). In the analysis of risk factors, Case and control groups of the brake History (respectively 40% and 6%), history of recent surgery (respectively 43% and 7%)and history of varicose veins (respectively 30% and 13%), these risk factors are significantly different (P<0.05), other factors no significant difference. Indicators in the laboratory, hemoglobin in the case group and control group were 106.03±14.27g/L and 118.83±12.69g/L, red blood cells were 3.84±0.54×109/L and 4.32±0.35×109/L, significant difference between the two (P <0.05), other indicators such as PaO2, PaCO2, and PLT no significant difference. The coagulation and anticoagulation, the case group and control group, APTT, PT,TT,Fib and the D-dimer were not significantly different. In the electrocardiogram, the case group and control group SⅠQⅢTⅢmainly were 13 cases (43%) and 16 patients (53%), but no significant difference between the two groups. The active thrombolytic and anticoagulant therapy after primary treatment, case and control groups were 17 cases (57%) and 27 patients (90%) improved, but there were 8 cases (26%) and 1 (3%) died, on the whole patient group compared with the control group had the poor treatment, high mortality rate.Conclusion:1. Malignant tumor due to brake operation and itself factors, prone to venous thrombosis.2. Cancer with PTE patients, treatment results are poor and the prognosis is poor.3. Malignant tumor of the patients without anticoagulation contraindications, should be given to preventive anticoagulant therapy.