恶性肿瘤并发急性下肢深静脉血栓形成的病因分析与治疗

目的：探讨恶性肿瘤患者并发急性下肢深静脉血栓（deep vein thrombosis of the lower extremity,DVT）的形成原因、诊断要点与治疗、护理及预防措施,为相关治疗提供参考。方法：回顾性分析了我院22例恶性肿瘤并发下肢深静脉血栓患者的临床病理表现,诊断方式及采取的治疗与护理措施,所有患者采用小-中等剂量尿激酶溶栓、同时予以低分子肝素钠抗凝、低分子右旋糖酐及丹参川芎嗪注射液辅助治疗,部分患者采取切除根治手术,分析比较患者的疗效。结果：采取上述治疗后21例患者取得了满意的效果,其中1例患者经治疗半月后效果不明显,进一步检查确诊为恶性淋巴瘤,还有1例患者经治疗好转出院3个月后再次出现对侧下肢深静脉血栓,进一步检查确诊为胆管癌。结论：DVT患者经联合抗凝、溶栓、祛聚、扩血管等综合治疗效果明显,以DVT为首发表现的患者治疗效果不佳或再发应及早考虑恶性肿瘤,以免漏诊,耽误原发病的治疗。

Analysis on cause of malignant tumor complicated with acute deep vein thrombosis in the lower extremity and its treatment

Objective： To investigate the cause of acute deep vein thrombosis of the lower extremity （DVT） in cancer patients and its diagnosis and treatments, care and preventive measures, and thus to provide reference for the relevant treatment. Methods： A retrospective analysis was carried on the clinical and pathological manifestations, diagnostic methods and treatment and care measures of 22 cases of malignant tumors in our hospital complicated with deep venous thrombosis in lower limb. All patients were treated with small-medium-dose urokinase as well as adjunctive therapy of low molecular weight sodium anticoagulation, dextran-40, and Salvia miltiorrhiza and Ligustrazine injection. Some patients underwent radical resection surgery. The curative effect were analyzed and compared between patients. Results： After taking the above treatment, 21 patients achieved satisfactory results. Only one patient after half a month＇s treatment yet got no obvious improvement, and further diagnosed as malignant lymphoma. Another patient turned better after treatment, but after 3 months he suffered deep vein thrombosis of the contralateral lower extremity, and further examination diagnosed as cholangiocarcinoma. Conclusion： Combined therapy of combined anticoagulation, thrombolysis, anti-platelet adhesion and vascular dilatation showed a good effect on DVT patients, but not on patients with DVT as the primary disease. When DVT patients recurred, early consideration of malignancies should be given in order to avoid misdiagnosis and delay of treatment to original disease.