在患有深静脉血栓症的癌症患者中应对外科期抗凝挑战:一个病例报告
Jacob George Binoy1, Greeshma George1, Dhanraj Parambeth2
1Trauma and Orthopaedics, Cumberland Infirmary, Carlisle, GBR.
Cureus
|February 6, 2026
概括
在老年癌症患者中治疗深静脉血栓症 (DVT) 需要平衡出血和凝血风险. 这一案例表明,对于瘤骨科患者来说,个性化抗凝调整至关重要.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 整形外科手术 整形外科手术
背景情况:
- 癌症患者的深静脉血栓症 (DVT) 管理,特别是术后,是复杂的,因为需要平衡血栓和出血风险.
- 患有转移性尿路细胞癌的老年患者在DVT管理方面存在独特的挑战.
研究的目的:
- 为了突出管理老年患者转移性尿癌和病理性股骨骨折的DVT的复杂性.
- 为了说明在瘤骨科患者中需要个性化和适应性抗凝策略的需要.
主要方法:
- 一份病例报告详细介绍了一名80岁的女性患者的治疗方法,该患者患有转移性尿路细胞癌,病态的股骨骨折和偶发的DVT.
- 实施下腔静脉 (IVC) 过器和个性化外科手术期间的埃诺沙巴林治疗方案.
- 基于手术延迟,术后并发症和贫血病的实时调整.
主要成果:
- 患者需要一个精心平衡的抗凝策略,涉及IVC过器和埃诺沙巴林,随后进行修改.
- 手术后的管理包括输血和抗凝剂调整,因为伤口的担忧和血红蛋白下降.
- 贫血是多因素的,低叶酸被识别和治疗,导致患者的稳定.
结论:
- 在瘤骨科患者的抗凝固管理需要个性化的方法,实时调整.
- 平衡血栓和出血风险至关重要,尤其是在面对不可预见的临床发展时.
- 患者在出院后开始使用阿皮克萨班终身抗凝药.
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