Ruff R L, Posner J B
Ann Neurol. 1983 Mar;13(3):334-6. doi: 10.1002/ana.410130320.
The incidence, prevention, and treatment of peripheral venous thrombosis were studied retrospectively in 381 patients with malignant glioma. Of 264 patients who did not receive antithrombotic prophylaxis, 97 (36.7%) developed clinical phlebitis confirmed by venography. Sixty-six cases occurred within 6 weeks of craniotomy. By contrast, only 12 (10%) of 117 patients who received intermittent pneumatic pressure to the calves during craniotomy developed phlebitis (4 patients with 6 weeks of the surgery). Of the 109 patients with venous thrombosis, 103 were treated with anticoagulants. Of the 6 patients treated conservatively, 3 died of pulmonary emboli. Intracranial hemorrhage occurred in 1.9% of the patients taking anticoagulants and in 2.2% of those who did not develop phlebitis. We conclude that patients with malignant gliomas have a high risk of developing peripheral venous thrombosis; that antithrombotic therapy reduces the incidence of thrombosis following craniotomy; and that, in patients who develop phlebitis, anticoagulation reduces the risk of pulmonary emboli without increasing the risk of intracranial hemorrhage.
对381例恶性胶质瘤患者的外周静脉血栓形成的发生率、预防和治疗进行了回顾性研究。在264例未接受抗血栓预防的患者中，97例（36.7%）经静脉造影证实发生了临床静脉炎。66例发生在开颅术后6周内。相比之下，在117例开颅手术期间接受小腿间歇性气压治疗的患者中，只有12例（10%）发生了静脉炎（4例发生在术后6周内）。在109例静脉血栓形成的患者中，103例接受了抗凝治疗。在6例保守治疗的患者中，3例死于肺栓塞。接受抗凝治疗的患者中有1.9%发生颅内出血，未发生静脉炎的患者中有2.2%发生颅内出血。我们得出结论，恶性胶质瘤患者发生外周静脉血栓形成的风险很高；抗血栓治疗可降低开颅术后血栓形成的发生率；并且，在发生静脉炎的患者中，抗凝治疗可降低肺栓塞的风险，而不会增加颅内出血的风险。
