JCO：ASCO更新癌症患者静脉血栓栓塞防治指南（2014）

2015-01-28 MedSci MedSci原创

2015年1月20日，JOURNAL OF CLINICAL ONCOLOGY在线发表了美国临床肿瘤学会（ASCO）临床实践指南2014年更新版本，此次更新旨在为肿瘤科医师及其他临床医生提供在治疗肿瘤患者时，对其静脉血栓栓塞（VTE）预防和治疗最新的指导方针。该临床实践指南基于临床实践经验编成，最早发表于2007年，在2013年进行了一次更新。来自美国华盛顿大学Fred Hutchinson肿

2015年1月20日，JOURNAL OF CLINICAL ONCOLOGY在线发表了美国临床肿瘤学会（ASCO）临床实践指南2014年更新版本，此次更新旨在为肿瘤科医师及其他临床医生提供在治疗肿瘤患者时，对其静脉血栓栓塞（VTE）预防和治疗最新的指导方针。

该临床实践指南基于临床实践经验编成，最早发表于2007年，在2013年进行了一次更新。来自美国华盛顿大学Fred Hutchinson肿瘤研究中心的Gary H. Lyman等研究人员组成了ASCO 临床实践指南更新审查委员会，通过在Pubmed、Cochrane Library等数据库中搜索2012年11月至2014年7月间的相关的随机分组对照临床试验、系统综述、Meta分析、以及临床实践指南等，并对其进行整理和分析，评估2013版的指南内容是否仍合理有效。

经过研究人员对53份相关出版物和文件进行确认和整理后，结果显示，对2013版指南未做改动，最新版指南内容在www.asco.org/guidelines/vte网站可查看。

以下为指南内容：

绝大部分患有活性强的肿瘤的住院患者在住院期间都应进行血栓预防；而对门诊肿瘤病人则不推荐进行常规血栓栓塞预防，仅对部分高风险患者考虑使用。

多发性骨髓瘤患者在接受抗血管生成药物联合化疗和/或地塞米松时应使用小分子量肝素（LMWH）或低剂量阿司匹林进行预防。

患者在接受大手术时栓塞预防应从手术前开始，并维持至术后7-10天止。

对须进行腹部或盆腔手术的栓塞高危患者还需考虑将预防手段延长至4周。

在治疗起初的5-10天建议使用LMWH，以预防深部静脉血栓形成和肺栓塞。

在进行长期的二次预防时（至少6个月）也推荐使用该药。对于恶性肿瘤和VTE患者，目前不推荐使用新的口服抗凝血剂，因为这些药在肿瘤患者中的各项数据尚缺。

在未发现肿瘤患者其他指征时，不应使用抗凝血剂来延长生存期。

对肿瘤患者应定期评估其VTE的风险。

肿瘤科医师及研究员应对患者普及VTE的风险、症状等相关知识。

原始出处

Gary H. Lyman, Kari Bohlke, Alok A. Khorana, Nicole M. Kuderer, Agnes Y. Lee, Juan Ignacio Arcelus, Edward P. Balaban, Jeffrey M. Clarke.Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update 2014.JCO.2014 文献.pdf

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2016-01-03 fusion

#静脉#

75 0
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2015-12-06 bioon3

#防治指南#

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2015-06-06 quxin068

#ASC#

75 0
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2015-01-28 lidong40

#JCO#

53 0
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2015-03-28 1249842em09(暂无昵称)

#癌症患者静脉血栓栓塞#

77 0
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2015-03-16 xue8602

#静脉血#

0 0
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2015-01-30 zgwhgch

#癌症患者#

62 0
[GetPortalCommentsPageByObjectIdResponse(id=1697241, encodeId=ab21169e241bc, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sun Jan 03 03:15:00 CST 2016, time=2016-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078304, encodeId=e48f20e8304e9, content=<a href='/topic/show?id=b6c09e42962' target=_blank style='color:#2F92EE;'>#防治指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97429, encryptionId=b6c09e42962, topicName=防治指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Sun Dec 06 20:15:00 CST 2015, time=2015-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938457, encodeId=306d193845edc, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Jun 06 18:15:00 CST 2015, time=2015-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1891167, encodeId=8923189116e17, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Wed Jan 28 19:15:00 CST 2015, time=2015-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1935357, encodeId=5781193535e0c, content=<a href='/topic/show?id=d427e135943' target=_blank style='color:#2F92EE;'>#癌症患者静脉血栓栓塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71359, encryptionId=d427e135943, topicName=癌症患者静脉血栓栓塞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sat Mar 28 09:15:00 CST 2015, time=2015-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955211, encodeId=8862195521123, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Mon Mar 16 05:15:00 CST 2015, time=2015-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289455, encodeId=393312894552d, content=<a href='/topic/show?id=cbb8e1356f7' target=_blank style='color:#2F92EE;'>#癌症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71356, encryptionId=cbb8e1356f7, topicName=癌症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=10ba218, createdName=zgwhgch, createdTime=Fri Jan 30 00:15:00 CST 2015, time=2015-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14756, encodeId=d88814e5699, content=据说肿瘤中静脉血栓致死比例达30%, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=42.122.193.**, createdTime=Wed Jan 28 09:27:00 CST 2015, time=2015-01-28, status=1, ipAttribution=)]
2015-01-28 42.122.193.**

据说肿瘤中静脉血栓致死比例达30%

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JCO：ASCO更新癌症患者静脉血栓栓塞防治指南（2014）

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