發(fā)布時間：2018-06-15 07:24

  本文選題：惡性腫瘤 + 靜脈血栓栓塞癥��； 參考：《石河子大學(xué)》2017年碩士論文

【摘要】：目的探討惡性腫瘤并靜脈血栓栓塞癥患者的相關(guān)危險因素。方法收集2015年11月-2016年9月在新疆自治區(qū)人民醫(yī)院住院患者病例資料及血樣標(biāo)本79例,包括17例確診惡性腫瘤并靜脈血栓栓塞癥患者(合并組),同期31例確診單純惡性腫瘤患者(單純腫瘤組)及31例確診單純靜脈血栓栓塞癥患者(單純栓塞組)。血樣標(biāo)本通過雙抗體一步夾心法酶聯(lián)免疫吸附試驗(ELISA)檢測血清因子含量。結(jié)果惡性腫瘤合并靜脈血栓栓塞癥多發(fā)生于高齡、肥胖、腫瘤中晚期、近期術(shù)后制動的患者。合并組患者以肺部惡性腫瘤合并靜脈血栓栓塞癥多見,其病理類型以腺癌為主,其次為消化系統(tǒng)、血液系統(tǒng)、泌尿生殖系統(tǒng)。合并組與對照組中肺癌和/或肺栓塞患者的主要臨床癥狀以呼吸困難、胸悶、胸痛最多見,體征以呼吸急促最多見,兩組無統(tǒng)計學(xué)差異(P0.05)。合并組與單純腫瘤組比較,ADAMTS-13、TT值減低,vWF、D-D、FIB值升高,有顯著統(tǒng)計學(xué)差異(P0.001)。合并組與單純栓塞組上述指標(biāo)比較,差異無統(tǒng)計學(xué)意義(P0.05)。接受正規(guī)治療的患者,合并組好轉(zhuǎn)8例,無效5例,死亡4例,單純栓塞組好轉(zhuǎn)25例,無效4例,死亡2例。合并組無效或死亡的比例明顯高于單純栓塞組(P0.05)。結(jié)論高齡、肥胖、腫瘤中晚期、近期術(shù)后制動的惡性腫瘤患者更易發(fā)生靜脈血栓栓塞癥。肺癌患者并發(fā)肺栓塞多見,呼吸困難、胸悶、胸痛及呼吸急促可提示我們肺栓塞發(fā)病可能。ADAMTS-13、vWF、D-D、FIB可能均具備獨立預(yù)測靜脈血栓栓塞風(fēng)險的意義。惡性腫瘤合并靜脈栓塞癥預(yù)后較差,我們應(yīng)對靜脈栓塞高危人群進行早期干預(yù)與治療。
[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.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R730.5

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本文編號：2021207