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目的 :本研究旨在探讨预防性抗凝治疗在预防低中危血栓风险恶性肿瘤患者血栓形成中的作用。方法 :选择Khorana模型评分≤2分且经静脉多普勒超声检查排除静脉血栓栓塞的146例恶性实体瘤患者,其中接受低分子量肝素预防性抗凝治疗的患者被纳入研究组(57例),未接受预防性抗凝治疗的患者被纳入对照组(89例)。比较2组的抗凝有效率、不良事件发生率、总生存和无进展生存时间。结果 :在83例低危患者中,研究组和对照组的抗凝有效率分别为93.10%和88.89%,差异无统计学意义(P=0.205);在63例中危患者中,研究组和对照组的抗凝有效率分别为85.71%和80.00%,差异亦无统计学无意义(P=0.182)。预防性抗凝治疗相关不良反应主要包括注射部位轻微瘀点、瘀斑和出血。研究组和对照组的总生存和无进展生存均无显著差异(P值均>0.05)。结论 :低中危恶性肿瘤患者可能无须接受预防性抗凝治疗以预防血栓形成。
Objective: This study was designed to investigate the role of prophylactic anticoagulant therapy in the prevention of thrombosis in patients with low-risk critical thrombotic malignancies. Methods: A total of 146 patients with malignant solid tumors with Khorana score ≤2 and venous Doppler echocardiography were excluded. Among the 57 patients who received prophylactic anticoagulation with low molecular weight heparin, Patients who did not receive prophylactic anticoagulant therapy were included in the control group (n = 89). The anticoagulation efficiency, the incidence of adverse events, overall survival and progression-free survival time were compared between the two groups. Results: Among 83 low-risk patients, the effective rates of anticoagulation in study group and control group were 93.10% and 88.89%, respectively, with no significant difference (P = 0.205). Among 63 moderate-risk patients, The anticoagulant efficacies in the control group were 85.71% and 80.00% respectively, with no significant difference (P = 0.182). Prophylactic anticoagulant therapy-related adverse reactions include minor petechia at the injection site, ecchymosis and bleeding. There was no significant difference between study group and control group in overall survival and progression-free survival (P> 0.05). Conclusions: Patients with low to intermediate risk malignancy may not need prophylactic anticoagulant therapy to prevent thrombosis.