Noble Simon I R, Finlay I G
Department of Palliative Medicine, Velindre Hospital, Whitchurch, Cardiff, UK.
Palliat Med. 2005 Apr;19(3):197-201. doi: 10.1191/0269216305pm1008oa.
Venous thromboembolism (VTE) is common in patients with terminal cancer. Current treatment practice with warfarin has a high incidence of complications, including bleeding, poor control and recurrent VTE. Long-term low-molecular-weight heparin (LMWH) therapy is safer and more efficacious in this patient group, but there are concerns that daily therapy may have a negative impact on quality of life. A qualitative study was carried out to determine whether LMWH was acceptable in palliative care patients, both in the community and in-patient units. Forty palliative care patients receiving LMWH for VTE were interviewed. Participants found LMWH to be an acceptable intervention, allowing them freedom from blood tests and optimism regarding their care. It was considered a preferable therapy to warfarin, which had a negative impact on participant's quality of life. The findings of this study support the use of LMWH, first line in the treatment of established VTE in the palliative care setting.
静脉血栓栓塞症（VTE）在晚期癌症患者中很常见。目前使用华法林的治疗方法并发症发生率很高，包括出血、控制不佳和VTE复发。长期使用低分子量肝素（LMWH）治疗在该患者群体中更安全、更有效，但有人担心每日治疗可能会对生活质量产生负面影响。开展了一项定性研究，以确定LMWH在社区和住院病房的姑息治疗患者中是否可接受。对40名因VTE接受LMWH治疗的姑息治疗患者进行了访谈。参与者发现LMWH是一种可接受的干预措施，使他们无需进行血液检查，并对自己的护理感到乐观。它被认为是比华法林更可取的治疗方法，华法林会对参与者的生活质量产生负面影响。本研究结果支持在姑息治疗环境中，将LMWH作为已确诊VTE的一线治疗药物。
