CAJ | 학술논문

恶性肿瘤通过多种机制激活凝血系统，引起高凝状态。高凝状态也能促进肿瘤细胞的增殖和转移。高凝状态易形成静脉血栓栓塞（venous thromboembolism，VTE），VTE是恶性肿瘤常见的并发症，能直接导致患者死亡。妇科恶性肿瘤患者是发生VTE的高危人群。 VTE是影响肿瘤患者生存率的重要因素。目前，临床指南推荐传统开腹手术患者术后立即进行最长达28 d的预防性抗凝治疗。对于进行微创手术的妇科肿瘤患者和术后进行化疗的患者，是否常规进行预防性抗凝治疗存在争议，仍需根据患者具体情况进行综合分析。肝素具有一定的抗肿瘤作用，但长期使用预防性抗凝治疗对恶性肿瘤患者预后的影响仍待进一步研究。
악성종류통과다충궤제격활응혈계통，인기고응상태。고응상태야능촉진종류세포적증식화전이。고응상태역형성정맥혈전전새（venous thromboembolism，VTE），VTE시악성종류상견적병발증，능직접도치환자사망。부과악성종류환자시발생VTE적고위인군。 VTE시영향종류환자생존솔적중요인소。목전，림상지남추천전통개복수술환자술후립즉진행최장체28 d적예방성항응치료。대우진행미창수술적부과종류환자화술후진행화료적환자，시부상규진행예방성항응치료존재쟁의，잉수근거환자구체정황진행종합분석。간소구유일정적항종류작용，단장기사용예방성항응치료대악성종류환자예후적영향잉대진일보연구。
Tumor cell can stimulate the procoagulant activity and induce a hypercoagulable state. This tumor hypercoagulability contributes to tumor growth, tumor metastasis and formation of venous thromboembolism. Women with a gynecologic malignancy are considered at high risk of venous thromboembolism (VTE). Studies demonstrated that VTE negatively impacted patients′ survival. Current guidelines recommend up to 28 days′ VTE thromboprophylaxis in the immediate postoperative period for patients undergoing open surgery. There are no established guidelines for women undergoing minimally invasive gynecologic surgery and chemotherapy. Appropriate prophylactic therapy should be considered according to each patient′s condition. Heparin is considered to have anti-tumor effect. Whether prolonged thromboprophylaxis can improve patients′survival needs further investigation.