引言

肺血栓栓塞癥（pulmonary thrombo embolism， PTE）是一種可以導(dǎo)致血栓阻塞部位遠(yuǎn)端的肺組織壞死的常見臨床疾病，一般通過血流瘀滯、血管壁損傷和血液高凝狀態(tài)為主要誘因，也被稱為肺栓塞的基本要素。目前，經(jīng)臨床試驗(yàn)證明腫瘤患者死亡的重要因素之一，腫瘤患者在患癌階段重要的并發(fā)癥是肺血栓栓塞癥[1]，該癥發(fā)病率在臨床試驗(yàn)中的統(tǒng)計(jì)結(jié)果為4%-20%，如何早期診斷、治療和預(yù)防該癌癥并發(fā)癥，成為國(guó)內(nèi)外臨床研究和亟需解決的重要問題。
腫瘤相關(guān)性PTE對(duì)患者的生活產(chǎn)生較為嚴(yán)重的影響，患者需要較長(zhǎng)時(shí)間進(jìn)行抗凝治療，經(jīng)臨床試驗(yàn)，腫瘤相關(guān)性PTE患者中12%有出血的并發(fā)癥[10]，就是使用了抗凝治療，，仍然有21%的患者復(fù)發(fā)；腫瘤相關(guān)性PTE患者需要延遲化療，嚴(yán)重者必須要停止化療；腫瘤相關(guān)性PTE患者，在放化療治療之外，還要額外占用醫(yī)療資源，這些不利后果，導(dǎo)致腫瘤相關(guān)性PTE患者的生活質(zhì)量較低[11-14]；腫瘤患者死亡的第一位原因是腫瘤本身，第二原因就是腫瘤相關(guān)性PTE，并且該并發(fā)癥是患者的短期及長(zhǎng)期的治愈主要難題。
長(zhǎng)期以來，多數(shù)國(guó)家認(rèn)為肺血栓栓塞癥不是常見病，在我國(guó)，更是認(rèn)為肺血栓栓塞癥并不常見，近年來，我國(guó)的醫(yī)務(wù)工作者開始認(rèn)識(shí)到該病癥的嚴(yán)重性，尤其是呼吸和心血管疾病的大夫，在臨床中經(jīng)常遇到肺血栓栓塞癥患者，他們的防治意識(shí)不斷增強(qiáng)，同時(shí)，我國(guó)的專業(yè)人士開始從事專門的研究，并且在預(yù)防和治療PTE方面取得了很大的進(jìn)展[15]。肺血栓栓塞癥被廣泛認(rèn)知的另一方面，是該病癥與惡性腫瘤息息相關(guān)，腫瘤是肺血栓栓塞癥的最危險(xiǎn)的誘發(fā)因素，然而，經(jīng)《2012中國(guó)腫瘤登記年報(bào)》統(tǒng)計(jì)，我國(guó)每分鐘有6人被診斷為癌癥，每年癌癥死亡病例高達(dá)270萬例，這個(gè)數(shù)據(jù)還在不斷的被刷新[16]。癌癥的高發(fā)率和高死亡率，讓癌癥并發(fā)癥也成為人們關(guān)注的首要問題，經(jīng)臨床研究顯示，惡性腫瘤患者中，PTE的發(fā)生率約為4%到20%[17]，并且肺血栓栓塞癥是惡性腫瘤患者死亡的主要因素。

1腫瘤合并肺栓塞的臨床表現(xiàn)
2 發(fā)病機(jī)制分析
3 危險(xiǎn)因素分析
4 腫瘤患者合并PTE的診斷
5 腫瘤患者合并PTE的治療
6 腫瘤患者PTE的預(yù)防

結(jié)語(yǔ)

通過最新的《2013年中國(guó)腫瘤登記年報(bào)》中披露，我國(guó)的癌癥發(fā)現(xiàn)速度已經(jīng)達(dá)到每分鐘6人，癌癥已經(jīng)成為我國(guó)死亡病因中占據(jù)比例比較高的一種惡性疾病，腫瘤患者的主要并發(fā)癥之一—PTE也是導(dǎo)致患者死亡的因素。在腫瘤患者合并PTE的研究中，大多對(duì)患者按照是否有轉(zhuǎn)移進(jìn)行劃分，而對(duì)患者的TNM分級(jí)以及PS評(píng)分等方面的研究較少，而腫瘤患者的TNM分級(jí)和體力狀態(tài)對(duì)合并PTE有著明顯的關(guān)系。同時(shí)，由于患者化療的治療過程記錄往往存在疏漏，造成對(duì)腫瘤合并PTE的量化分析帶來一定的難度。為了更好地開展腫瘤合并PTE的預(yù)防，加強(qiáng)這方面的普及教育，需要從臨床醫(yī)生入手，詳細(xì)分析腫瘤合并PTE的為危險(xiǎn)因素、治療方案以及預(yù)防方案，從而改善腫瘤患者的治療條件。

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