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目的探讨接受不同抗肿瘤治疗的恶性实体瘤患者凝血指标的变化规律及其临床意义。方法定量检测恶性实体瘤未治疗组、手术组、放化疗组及对照组受检者的血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)和D-二聚体(D-D)水平并进行对比分析,同时进行组间差异性比较。结果恶性实体瘤未治疗组、手术组、放化疗组、对照组上述凝血指标比较差异均有统计学意义(P<0.05);恶性实体瘤未治疗组与放化疗组比较,各项凝血指标间差异无统计学意义(P>0.05);恶性实体瘤未治疗组的血浆FIB及D-D水平均高于手术组(P<0.05);恶性实体瘤放化疗组的血浆FIB水平高于手术组(P<0.05)。结论恶性实体瘤患者的血液异常状态受其治疗方式的影响;恶性实体瘤患者不论采取手术还是放化疗,在治疗结束后1个月仍存在凝血功能异常;接受手术治疗的恶性实体瘤患者,血液高凝状态可暂时缓解,但仍存在血栓形成及继发出血的风险。
Objective To investigate the variation of coagulation index and its clinical significance in patients with malignant solid tumors receiving different anti-tumor therapy. Methods The levels of platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time in untreated group, operation group, radiotherapy and chemotherapy group and control group were determined. (TT), fibrinogen (FIB) and D-dimer (DD) levels were compared and analyzed. At the same time, the differences between groups were compared. Results There was significant difference in coagulation index between untreated group, operation group, radiotherapy and chemotherapy group and control group (P <0.05). Compared with chemoradiotherapy group, no significant difference was found between coagulation index (P> 0.05). The levels of plasma FIB and DD in untreated patients with malignant solid tumors were significantly higher than those in operation group (P <0.05). The plasma FIB levels in radiotherapy and chemotherapy group were higher than those in operation group <0.05). Conclusion The abnormal blood state of patients with malignant solid tumors is influenced by the way of treatment. The patients with malignant solid tumors still have coagulation abnormalities 1 month after the operation, regardless of the operation or radiotherapy and chemotherapy. In the patients with malignant solid tumors undergoing surgery, the blood Hypercoagulable state can be temporarily alleviated, but there is still the risk of thrombosis and secondary bleeding.