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Blood:静脉置管的肿瘤患者发生血栓的风险评估

2018-07-08 MedSci MedSci原创

目前,准确鉴别有高血栓并发症风险的癌症门诊患者的需求仍未得到满足。Hervé Decousus等人进行一前瞻性的多中心的队列研究,招募固体肿瘤成年患者,静脉置管后随访12个月。主要评估指标是鉴别导管相关的血栓风险(同侧有症状的上肢深静脉血栓形成伴或不伴肺栓塞)和除了导管相关以外的静脉血栓栓塞(任何症状的浅表或深静脉血栓或肺栓塞,和偶发性肺栓塞)。总体上,本研究共纳入3032位患者,中位年龄63岁,

目前,准确鉴别有高血栓并发症风险的癌症门诊患者的需求仍未得到满足。Hervé Decousus等人进行一前瞻性的多中心的队列研究,招募固体肿瘤成年患者,静脉置管后随访12个月。主要评估指标是鉴别导管相关的血栓风险(同侧有症状的上肢深静脉血栓形成伴或不伴肺栓塞)和除了导管相关以外的静脉血栓栓塞(任何症状的浅表或深静脉血栓或肺栓塞,和偶发性肺栓塞)。

总体上,本研究共纳入3032位患者,中位年龄63岁,女性占58%。癌症类型主要是乳腺癌(33.7%)、肺癌(18.5%)和大肠癌(15.6%);43.2%的患者癌症已转移。大多数患者(97.1%)进行过化疗。12周时,48位(1.6%)患者失访,656位(24.6%)患者死亡;3.8%(111位)的患者发生过导管相关的血栓,9.6%(276位)的患者发生过非导管相关的静脉血栓。

根据多变量分析,采用头静脉进行导管置管好发生导管相关的血栓,而进行抗血小板治疗可预防血栓形成;非导管相关的静脉血栓栓塞的风险因素包括高龄、静脉血栓史、癌症位置和化疗前低血红蛋白水平或白细胞增多。

总而言之,该大规模的前瞻性队列研究显示进行静脉置管的实体肿瘤患者发生静脉血栓栓塞的风险较高。导管相关的血栓风险与非导管相关的静脉血栓的风险不同。

原始出处:

Hervé Decousus,et al. Cancer-associated thrombosis in patients with implanted ports: a prospective multicenter French cohort study (ONCOCIP). Blood  2018  :blood-2018-03-837153;  doi: https://doi.org/10.1182/blood-2018-03-837153

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    2018-09-18 fusion
  2. [GetPortalCommentsPageByObjectIdResponse(id=1697724, encodeId=0bcb169e72455, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, 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=Tue Sep 18 01:49:00 CST 2018, time=2018-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1424247, encodeId=f042142424e35, content=<a href='/topic/show?id=94c182929d0' target=_blank style='color:#2F92EE;'>#肿瘤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82929, encryptionId=94c182929d0, topicName=肿瘤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60943920553, createdName=lanyan20020087, createdTime=Tue Jul 10 05:49:00 CST 2018, time=2018-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330258, encodeId=875733025897, content=管置管好发生导管相关的血栓.而进行抗血小板治疗可预防血栓形成,, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 08 23:28:40 CST 2018, time=2018-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330219, encodeId=50b0330219fa, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Sun Jul 08 22:04:08 CST 2018, time=2018-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330190, encodeId=4d45330190ec, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sun Jul 08 16:56:21 CST 2018, time=2018-07-08, status=1, ipAttribution=)]
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    2018-07-08 随梦飞扬

    管置管好发生导管相关的血栓.而进行抗血小板治疗可预防血栓形成,

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1697724, encodeId=0bcb169e72455, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, 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=Tue Sep 18 01:49:00 CST 2018, time=2018-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1424247, encodeId=f042142424e35, content=<a href='/topic/show?id=94c182929d0' target=_blank style='color:#2F92EE;'>#肿瘤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82929, encryptionId=94c182929d0, topicName=肿瘤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60943920553, createdName=lanyan20020087, createdTime=Tue Jul 10 05:49:00 CST 2018, time=2018-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330258, encodeId=875733025897, content=管置管好发生导管相关的血栓.而进行抗血小板治疗可预防血栓形成,, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 08 23:28:40 CST 2018, time=2018-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330219, encodeId=50b0330219fa, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Sun Jul 08 22:04:08 CST 2018, time=2018-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330190, encodeId=4d45330190ec, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sun Jul 08 16:56:21 CST 2018, time=2018-07-08, status=1, ipAttribution=)]
    2018-07-08 一天没事干

    很好的学习机会

    0

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    2018-07-08 131****1460

    学习了受益匪浅

    0

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