Kamphuisen Pieter W, Beyer-Westendorf Jan
Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Division of Vascular Medicine, Department of Medicine, Technical University Dresden, Dresden, Germany.
Thromb Res. 2014 May;133 Suppl 2:S49-55. doi: 10.1016/S0049-3848(14)50009-6.
Patients with cancer have an increased risk of bleeding complications, of which some are fatal. This risk is influenced by chemotherapy, cancer type and stage, thrombocytopenia, renal function, and previous bleeding. Since many cancer patients receive anticoagulant treatment for prophylaxis or treatment of venous thromboembolism (VTE), bleeding complications are a challenge in clinical practice. This review article focuses on the overall bleeding risk of cancer patients and the risk of major and clinically relevant bleeding associated with anticoagulant treatment, such as vitamin K antagonists, LMWH and the direct oral anticoagulants. It also describes strategies for individual risk assessments.
癌症患者发生出血并发症的风险增加，其中一些是致命的。这种风险受化疗、癌症类型和分期、血小板减少、肾功能以及既往出血情况的影响。由于许多癌症患者接受抗凝治疗以预防或治疗静脉血栓栓塞（VTE），出血并发症在临床实践中是一项挑战。这篇综述文章重点关注癌症患者的总体出血风险以及与抗凝治疗相关的大出血和临床相关出血风险，如维生素K拮抗剂、低分子肝素和直接口服抗凝剂。它还描述了个体风险评估策略。
