肺癌患者合并肺栓塞的危险因素分析

Analysis of Risk Factors for Pulmonary Embolism in Lung Cancer Patients

摘要: 肺癌是目前临床最常见且危害最大的恶性肿瘤之一，静脉血栓栓塞症(venous thromboembolism, VTE)是其常见的并发症，VTE包括深静脉血栓形成(deep venous thrombosis, VTE)和肺栓塞(pulmonary embolism, PE)，大量研究表明，肺血栓栓塞(Pulmonary thromboembolism, PE)是肺癌患者住院期间除癌症本身以外的第二大死亡原因，病死率增加2~8倍，同时严重影响患者的生存时间及治疗费用，肺腺癌是非小细胞肺癌(non-small cell lung cancer, NSCLC)中VTE发生率最高的病理分型。但由于症状和体征缺乏特异性，临床上仅约1/4的患者有典型的“三联征”表现，即同时出现呼吸困难、咯血和胸痛，故症状缺乏特异性，难以识别，临床中易造成误诊和漏诊，对病人的生命安全构成极大的威胁，是肺癌患者预后不良的标志之一，故而对于肺癌病人发生肺栓塞的准确预测至关重要。本综述主要侧重于阐述肺腺癌患者形成PE的危险因素分析及相关治疗进展。

Abstract: Lung cancer is currently one of the most common and harmful malignant tumors in clinical practice, and venous thromboembolism (VTE) is a common complication. VTE includes deep venous thrombosis (VTE) and pulmonary embolism (PE). Numerous studies have shown that pulmonary thromboembolism (PE) is the second leading cause of death in lung cancer patients during hospitalization, after the cancer itself, with a mortality rate that increases by 2~8 times. At the same time, it seriously affects the patient’s survival time and treatment costs. Adenocarcinoma of the lung is a pathological classification with the highest incidence of VTE in non-small cell lung cancer (NSCLC). However, due to the lack of specificity in symptoms and signs, only about 1/4 of patients in clinical practice have typical “triad” symptoms, which include difficulty breathing, hemoptysis, and chest pain. Therefore, the symptoms lack specificity and are difficult to identify, which can easily lead to misdiagnosis and missed diagnosis in clinical practice, posing a great threat to the patient’s life safety and being one of the indicators of poor prognosis in lung cancer patients. Therefore, accurate prediction of pulmonary embolism in lung cancer patients is crucial. This review mainly focuses on the analysis of risk factors for PE formation in patients with lung adenocarcinoma and related treatment progress.