Meyer Guy
Service de pneumologie, soins intensifs, Hôpital européen Georges-Pompidou, AP-HP, 75908 Paris Cedex 15.
Rev Prat. 2011 Nov;61(9):1249-51.
Venous thromboembolism occurs in about 10% of patients with cancer. In this setting, vitamin K antagonists have been associated with a high risk of recurrent disease and major bleeding. Low-molecular-weight heparin allows reducing by 50% the rate of recurrent venous thromboembolism as compared to vitamin K antagonists. Even with low-molecular-weight heparin, recurrent venous thromboembolism occurs in up to 6% of the patients. In this case it has been suggested to increase the dosage of low-molecular-weight heparin. Vena cava filtration probably plays a minor role in setting. After the sixth month, prolongation of low-molecular-weight-heparin or switch to vitamin K antagonist should be discussed on a case by case basis.
静脉血栓栓塞症在约10%的癌症患者中发生。在这种情况下，维生素K拮抗剂与疾病复发和严重出血的高风险相关。与维生素K拮抗剂相比，低分子量肝素可使静脉血栓栓塞症的复发率降低50%。即使使用低分子量肝素，仍有高达6%的患者会发生复发性静脉血栓栓塞症。在这种情况下，建议增加低分子量肝素的剂量。腔静脉滤过在这种情况下可能作用较小。六个月后，应根据具体情况讨论是否延长低分子量肝素的使用时间或改用维生素K拮抗剂。
