Effect of vascular interventional therapy on coagulation function in patients with advanced tumors: a retrospective study
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摘要:
目的 研究中晚期肿瘤患者血管介入治疗前后凝血功能的变化。 方法 回顾性分析2018年1月至2018年10月于首都医科大学附属北京中医医院行血管介入治疗的174例中晚期肿瘤患者，观察血管介入治疗前后血小板及相关凝血指标的变化。血管介入治疗后1周内行相关指标检测的63例患者设为A组，血管介入治疗后1个月（30±7天）行相关指标检测的111例患者设为B组。数据采用SPSS 22.0软件进行统计学分析。 结果 A组纤维蛋白原（FIB）、D-D二聚体（D-D）值较治疗前显著升高，活化部分凝血活酶时间（APTT）缩短，血小板（PLT）值较治疗前降低（均P < 0.05）；B组FIB、D-D、PLT值较治疗前降低，凝血酶原时间（PT）、APTT较治疗前延长（P>0.05）；血管介入治疗前，共58例患者伴有血液高凝状态，其中A组28例（48.3%），B组30例（51.7%）；血管介入治疗后，共71例（40.8%）患者伴有血液高凝状态，其中A组40例（56.3%），B组31例（43.7%）。 结论 血管介入治疗在短期内可影响相关凝血指标，加剧中晚期肿瘤患者的血液高凝状态，但随着时间延长，对患者凝血功能的影响逐渐降低，相关血凝指标可逐渐恢复至治疗前水平，建议在血管介入治疗后密切监测患者凝血功能变化。 Abstract:Objective To study the changes in coagulation function in patients with advanced tumors before and after vascular interventional therapy. Methods A total of 174 patients with middle-late stage tumors undergoing oncology vascular interventional treatment at Beijing Hospital Of Traditional Chinese Medicine Affiliated With Capital Medical University, between January 2018 and October 2018 were included in this retrospective analysis. Changes in platelets (PLT) and related blood coagulation indicators were observed before and after vascular intervention. Among them, 63 patients who received relevant indicators detection within a week after vascular intervention were in group A, and 111 patients who received relevant indicators detection 1 month (30±7 days) after vascular intervention were in group B. SPSS version 22 software was used for statistical analysis. Results In group A, fibrinogen (FIB) and D-dimer (D-D) values significantly increased, activated pattial thromboplastin time(APIT)shortened, and PLT values decreased compared to those before treatment (all P < 0.05). In group B, the FIB, D-D, and prothrombin time (PT) count were lower and the PLT and APTT times were longer (P>0.05) than those before treatment. Before vascular interventional therapy, a total of 58 patients had hypercoagulability, including 28 patients in group A (48.3%) and 30 patients in group B (51.7%). In contrast, after vascular interventional therapy, a total of 71 (40.8%) patients had hypercoagulability, including 40 (56.3%) patients in group A and 31 (43.7%) patients in group B. Conclusions Vascular interventional treatment can affect the related blood clotting index in the short term, which is intensified in patients with middle-late tumors and a high blood coagulation state. However, over time the coagulation state gradually mitigated and eventually returned to before-treatment levels. These findings suggest that patients' coagulation function should be closely monitored after intervention treatment. -
表 1 174例中晚期恶性肿瘤患者临床资料
表 2 不同癌种治疗前相关血凝指标差异
表 3 A组相关血凝指标的变化
表 4 B组相关血凝指标的变化
表 5 治疗前后符合血液高凝状态病例的比较
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