| Objective:1 Analyzing malignant tumor patients associated venous thromboembolism(VTE) of the clinical factors.2 Retrospective analysis of malignant tumor patients associated VTE from Shanxi DAYI Hospital, identify the current situation of the diagnosis and treatment.3 Guiding the clinical malignant tumor patients associated VTE with effective prevention and early treatment, improving the patients’ life quality and prolonging the survival period.4 Providing the theoretical foundation for the clinical standardization of diagnosis and treatment of malignant tumor patients associated VTE. Methods:54 cancer patients associated VTE who hospitalized from April 2012 to May 2014 in Shanxi DAYI Hospital vascular surgery were enrolled. The clinical factors including: general information(patients’ gender and age), thrombus(by stages, classification, with PTE or not), risk factors(High blood pressure, diabetes, kidney disease syndrome, surgery and/not postoperative immobilize, paralysis and/not stay in bed, chemotherapy, radiation therapy, chronic venous insufficiency in lower extremity, indwelling central venous line), tumor(types, TNM, the time of the VTE), Blood laboratory indexes(Fibrinogen, D-dimer, antithrombin-Ⅲand blood platelet count). Analyzing statistic those factors’ relationship. Results:1 In all the patients, the number of patients with 40-79 age group with the most cases and the proportion was 88.8%. In different age ranges, there was no statistically significant differences in patients between male and female(P =0.094).2 92.6% malignant tumor associated VTE patients happen to lower limbs.33.3% patients with PTE, 64.8% patients in acute stage.3 The different incidence of left and right lower limbs was statistically significant(2c =6.783, P =0.009);the mixed-type thrombus different incidence of left and right lower limbs was statistically significant(2c =5.263, P =0.022); The different incidence of left and right lower limbs in central-type and peripheral-type thrombus has no obvious relation(P =1.000;2c =0.783, P =0.376).4 In accordance with the composition ratio of the top five risk factors related to malignant tumor associated VTE are:chemotherapy(64.8%),surgery and/not postoperative immobilize(61.1%),paralysis and/not stay in bed(48.1%),High blood pressure(29.6%), radiation therapy(24.1%).3 upper limb cases with DVT are all indwelling central catheter.5 Top three tumor distribution of cancer patients with VTE respectively are: the digestive tract tumors, gynecological tumors, urinary tract tumors. Patients with tumor stage forⅢ–Ⅳaccounted for 72.2% of total cases.6 There are 74.0% malignant tumor patients with VTE in 6 months after the diagnosis of tumor incident, another 13.0% patients occur thrombus at the same time with the tumor event, or even earlier.7 31.5% malignant tumor patients with VTE have fibrinogen increase;92.6% patients have the D- dimer increase;25.9% patients have a lower trend in antithrombin-Ⅲ;31.5% patients have blood platelet count abnormalities. Conclusions:1 The patients whose age between 40-79 years old have high incidence of malignant tumors with VTE.2 Mostly thrombus events develops in the acute phase. Thrombus events have a high incidence in lower limbs.3 The top five risk factors of malignant tumor associated VTE are : chemotherapy, surgery and/not postoperative immobilize, paralysis and/not stay in bed, High blood pressure, radiation therapy. Indwelling central catheter is the important risk factor of upper extremity DVT.4 The incidence of VTE was high in gastrointestinal tumors, gynecological tumors and urinary tract tumors. Advanced disease patients with TNM stage Ⅲ – Ⅳ are more likely to merge the thrombus.5 More cancer associated VTE patients develop thrombotic events within 6 months.6 There are some kinds of malignant tumor with the first clinical manifestation of thrombus.7 The relationship among the four laboratory indexes that fibrinogen, D-dimer, antithrombin-Ⅲ and blood platelet count closely associated with thrombosis. |
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