Kakkar A K, Williamson R C
Department of Surgery, Imperial College School of Medicine, Hammersmith Hospital, London, United Kingdom.
Semin Thromb Hemost. 1999;25(2):239-43. doi: 10.1055/s-2007-994925.
Thrombosis is a common complication in patients with malignancy and its occurrence is heightened by therapeutic interventions such as operations or the use of chemotherapy. The magnitude of the risk for venous thromboembolism (VTE) is well established for cancer surgery where rates twice that for abdominal surgery in noncancer subjects are described. The case for routine thromboprophylaxis in patients receiving chemotherapy is less clear, and prospective studies investigating rates of thrombosis by tumor type, stage of disease, and chemotherapeutic regimens are required. For thromboprophylaxis in the surgical patient either low-dose heparin or low-molecular-weight (LMW) heparin are effective and safe. For patients receiving chemotherapy in advanced breast cancer, low-dose warfarin is effective. Interestingly, heparin therapy may prolong survival in patients with malignant disease; the mechanism is unclear, and observations from retrospective analysis need to be confirmed in prospective studies.
血栓形成是恶性肿瘤患者常见的并发症，手术或化疗等治疗干预会增加其发生风险。静脉血栓栓塞（VTE）在癌症手术中的风险程度已得到充分证实，其发生率是非癌症患者腹部手术的两倍。对于接受化疗的患者，常规血栓预防的情况尚不清楚，需要进行前瞻性研究，以调查不同肿瘤类型、疾病分期和化疗方案的血栓形成率。对于外科手术患者，低剂量肝素或低分子量（LMW）肝素进行血栓预防既有效又安全。对于晚期乳腺癌接受化疗的患者，低剂量华法林有效。有趣的是，肝素治疗可能会延长恶性疾病患者的生存期；其机制尚不清楚，回顾性分析的观察结果需要在前瞻性研究中得到证实。
