肿瘤与血栓形成课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,肿瘤与血栓形成,Tumor and thrombosis,肿瘤与血栓形成,1,Thrombosis and Cancer:,o Cancer is an independent risk factor for VTE,increases risk by 4-to 6-fold,o-25%of vte cases are associated with cancer,acute VTE 20%have known cancer,idiopathic VTE 10%have cancer within 12 months,2,关系,0,cancer,bod,thrombosis,3,0,静脉血栓性栓塞症(enous,thromboembolism,VTE)E,流行病学,4,0,胰腺癌,肺癌,胃癌,大肠癌,绝经前乳癌,口绝经后乳癌,5,血栓形成的高危因素,0,o Risk of vte in cancer patients depends on,-tumour type(腺癌),stage or extent of cancer,location(venous obstruction),anti-tumour therapy(chemo,hormone,anti-VEGF,tissue trauma(surgery,central venous catheters),other risk factors(e.g,immobility,previous VTE),6,0,surgery 30,enous,catheteri,口 chemotherapy9,口 other treatment2,7,其它治疗因素,0,EPo(癌性贫血),他莫昔芬(乳腺癌),激素(淋巴系统肿瘤),反应停(MM等),贝伐单抗(大肠癌、肺癌等),8,病理生理学,0,1.和所有类型的血栓形成一样,癌症病人的,VTE也涉及,a)血行停滞(stasis,b)血管伤害(vessel injury),C)血液的高凝固性状态(hypercoagulable state,of blood,其中肿瘤细胞引发的高凝固性状态是最重要和,最具决定性的因素,9,病理生理学,0,2.癌症病人的血行停滞(stasis)是由于:,a)卧床不动(immobilisation),b)卧床休息(bed rest,C)巨大肿瘤肿块的静脉压迫(venous,compression),10,肿瘤与血栓形成课件,11,肿瘤与血栓形成课件,12,肿瘤与血栓形成课件,13,肿瘤与血栓形成课件,14,肿瘤与血栓形成课件,15,肿瘤与血栓形成课件,16,肿瘤与血栓形成课件,17,肿瘤与血栓形成课件,18,肿瘤与血栓形成课件,19,肿瘤与血栓形成课件,20,肿瘤与血栓形成课件,21,肿瘤与血栓形成课件,22,肿瘤与血栓形成课件,23,肿瘤与血栓形成课件,24,肿瘤与血栓形成课件,25,肿瘤与血栓形成课件,26,肿瘤与血栓形成课件,27,肿瘤与血栓形成课件,28,肿瘤与血栓形成课件,29,肿瘤与血栓形成课件,30,肿瘤与血栓形成课件,31,肿瘤与血栓形成课件,32,肿瘤与血栓形成课件,33,肿瘤与血栓形成课件,34,肿瘤与血栓形成课件,35,肿瘤与血栓形成课件,36,肿瘤与血栓形成课件,37,