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癌症相关静脉血栓栓塞的防治指南。

Guidance for the prevention and treatment of cancer-associated venous thromboembolism.

作者信息

Khorana Alok A, Carrier Marc, Garcia David A, Lee Agnes Y Y

机构信息

Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland Clinic, 9500 Euclid Ave, R35, Cleveland, OH, 44195, USA.

Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.

出版信息

J Thromb Thrombolysis. 2016 Jan;41(1):81-91. doi: 10.1007/s11239-015-1313-4.

Abstract

Venous thromboembolism (VTE) is a highly prevalent complication of malignancy with emerging changes in incidence, diagnosis and treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. We address a) the appropriate workup to search for occult malignancy in patients with idiopathic VTE, b) identification of high-risk cancer patients for primary thromboprophylaxis, c) the appropriate immediate and long-term treatment for people with cancer diagnosed with acute thromboembolism, d) the appropriate duration of anticoagulation and e) the appropriate treatment strategy in patients with recurrent VTE on anticoagulation. Areas of controversy and future directions in this field are highlighted.

摘要

静脉血栓栓塞症(VTE)是恶性肿瘤一种非常常见的并发症,其发病率、诊断和治疗模式都在不断变化。这份由抗凝论坛发起的手稿,基于现有指南以及在缺乏指南时的专家共识意见,提供临床指导。我们讨论了以下内容:a)对特发性VTE患者进行隐匿性恶性肿瘤筛查的适当检查方法;b)识别需要进行一级血栓预防的高危癌症患者;c)对诊断为急性血栓栓塞症的癌症患者进行适当的即刻和长期治疗;d)抗凝治疗的适当疗程;e)接受抗凝治疗的复发性VTE患者的适当治疗策略。文中还强调了该领域存在争议的方面和未来的发展方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae6a/4715852/fb68f012cc40/11239_2015_1313_Fig1_HTML.jpg

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