Paffenholz Pia
Urologie, Universitätsklinikum Köln, Köln, Germany.
Aktuelle Urol. 2024 Feb;55(1):44-49. doi: 10.1055/a-2099-8233. Epub 2023 Jun 20.
Venous thromboembolism is an important complication in tumour patients as it occurs frequently in these patients and causes relevant morbidity. The risk of thromboembolic complications in tumour patients is 3-9 times higher than in non-tumour patients and is the second most common cause of death in tumour patients. The risk of thrombosis depends on tumour-induced coagulopathy and on individual factors, type and stage of cancer, time since cancer diagnosis as well as type of systemic cancer therapy. Thromboprophylaxis in tumour patients is effective but can be associated with increased bleeding. Even though there are currently no dedicated recommendations for individual tumour entities, international guidelines recommend prophylactic measures in high-risk patients. A thrombosis risk of >8-10% can be considered an indication for thromboprophylaxis, which is indicated by a Khorana score ≥2, and should be calculated individually using nomograms. In particular, patients with a low risk of bleeding should receive thromboprophylaxis. Risk factors and symptoms of a thromboembolic event should also be intensively discussed with the patient and materials for patient information should be handed out.
静脉血栓栓塞是肿瘤患者的一种重要并发症,因为它在这些患者中频繁发生并导致相关的发病率。肿瘤患者发生血栓栓塞并发症的风险比非肿瘤患者高3至9倍,是肿瘤患者第二常见的死亡原因。血栓形成的风险取决于肿瘤诱导的凝血病以及个体因素、癌症的类型和分期、癌症诊断后的时间以及全身癌症治疗的类型。肿瘤患者的血栓预防是有效的,但可能会增加出血风险。尽管目前没有针对个别肿瘤实体的专门建议,但国际指南建议对高危患者采取预防措施。血栓形成风险>8-10%可被视为血栓预防的指征,这可通过Khorana评分≥2来表明,并且应使用列线图单独计算。特别是出血风险低的患者应接受血栓预防。还应与患者深入讨论血栓栓塞事件的危险因素和症状,并发放患者信息资料。