切换至 "中华医学电子期刊资源库"

中华介入放射学电子杂志 ›› 2019, Vol. 07 ›› Issue (04) : 322 -329. doi: 10.3877/cma.j.issn.2095-5782.2019.04.013

所属专题: 文献

综述

恶性肿瘤相关静脉血栓栓塞症及治疗进展
武贝1, 陈国平2, 顾建平2,()   
  1. 1. 210009 南京医科大学附属肿瘤医院(江苏省肿瘤医院)介入科
    2. 210006 南京医科大学附属南京医院(南京市第一医院)介入科
  • 收稿日期:2019-09-06 出版日期:2019-11-01
  • 通信作者: 顾建平
  • 基金资助:
    江苏省临床医学科技专项项目"急性下肢深静脉血栓形成介入诊疗规范化研究"(BL2014013)

Progress in Malignant tumor related venous thromboembolismand its treatment

Bei Wu1, Guoping Chen2, Jianping Gu2()   

  • Received:2019-09-06 Published:2019-11-01
  • Corresponding author: Jianping Gu
引用本文:

武贝, 陈国平, 顾建平. 恶性肿瘤相关静脉血栓栓塞症及治疗进展[J/OL]. 中华介入放射学电子杂志, 2019, 07(04): 322-329.

Bei Wu, Guoping Chen, Jianping Gu. Progress in Malignant tumor related venous thromboembolismand its treatment[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2019, 07(04): 322-329.

肿瘤相关血栓形成(CAT)是肿瘤患者常见的并发症,也是肿瘤患者高发病率和高死亡率的重要原因。肿瘤类型、分期、肿瘤衍生因子和遗传因素及抗肿瘤治疗均可增加CAT的风险。正确识别和治疗高风险CAT对提高肿瘤患者的生存率至关重要。目前指南建议低分子肝素(LMWH)作为CAT长期抗凝治疗的首选,但长期使用存在一些实际问题。新型口服抗凝剂(NOACs)在肿瘤患者治疗中的疗效和安全性数据有限。125I粒子条联合血管支架已成为CAT腔内治疗新的研究热点,已发表的数据较少,主要是个案报道和小样本研究,需要进一步的研究来更新和改进CAT风险评估和治疗指南。

[1]
van Es N, Le Gal G, Otten HM,et al. Screening for occult cancer in patients with unprovoked venous thromboembolism[J]. Ann Intern Med,2017,167(6):410.
[2]
Streiff MB, Holmstrom B, Ashrani A,et al. Cancer-associated venous thromboembolic disease,version 1.2015[J]. J Natl Compr Canc Netw,2015,13(9):1079-1095.
[3]
Farge D, Bounameaux H, Brenner B,et al. International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer[J]. Lancet Oncol,2016,17(10):e452-e466.
[4]
Kearon C, Akl EA, Ornelas J,et al. Antithrombotic therapy for VTE disease:CHEST guideline and expert panel report[J]. Chest,2016,149(2):315-352.
[5]
Key NS, Khorana AA, Kuderer NM,et al. Venous thromboembolism prophylaxis and treatment in patients with cancer:ASCO clinical practice guideline update[J]. J Clin Oncol,2019:JCO1901461.
[6]
Niu S, Xu YS, Cheng L,et al. Stent insertion for malignant superior vena cava syndrome:effectiveness and long-term outcome[J]. Radiol Med,2017,122(8):633-638.
[7]
Büstgens FA, Loose R, Ficker JH,et al. Stent implantation for superior vena cava syndrome of malignant cause[J]. Rofo,2017,189(5):423-430.
[8]
O'Sullivan GJ, Waldron D, Mannion E,et al. Thrombolysis and iliofemoral vein stent placement in cancer patients with lower extremity swelling attributed to lymphedema[J]. J Vasc Interv Radiol,2015,26(1):39-45.
[9]
Maleux G, Vertenten B, Laenen A,et al. Palliative endovascular treatment of cancer-related iliocaval obstructive disease:technical and clinical outcomes[J]. Acta Radiol,2016,57(4):451-456.
[10]
Walker AJ, Card TR, West J,et al. Incidence of venous thromboembolism in patients with cancer-a cohort study using linked United Kingdom databases[J]. Eur J Cancer,2013,49(6):1404-1413.
[11]
Zayed MA, De Silva GS, Ramaswamy RS,et al. Management of cavoatrial deep venous thrombosis:incorporating new strategies[J]. Semin Intervent Radiol,2017,34(1):25-34.
[12]
Prandoni P, Falanga A, Piccioli A. Cancer and venous thromboembolism[J]. Lancet Oncol,2005,6(6):401-410.
[13]
Ageno W, Haas S, Weitz JI,et al. Characteristics and management of patients with venous thromboembolism:the GARFIELD-VTE registry[J]. Thromb Haemost,2019,119(2):319-327.
[14]
Timp JF, Braekkan SK, Versteeg HH,et al. Epidemiology of cancer-associated venous thrombosis[J]. Blood,2013,122(10):1712-1723.
[15]
Riedl J, Kaider A, Reitter EM,et al. Association of mean platelet volume with risk of venous thromboembolism and mortality in patients with cancer. results from the Vienna cancer and thrombosis study(CATS)[J]. Thromb Haemost,2014,111(4):670-678.
[16]
Gussoni G, Frasson S, La Regina M,et al. Three-month mortality rate and clinical predictors in patients with venous thromboembolism and cancer. Findings from the RIETE registry[J]. Thromb Res,2013,131(1):24-30.
[17]
Kourelis TV, Wysokinska EM, Wang Y,et al. Early venous thromboembolic events are associated with worse prognosis in patients with lung cancer[J]. Lung Cancer,2014,86(3):358-362.
[18]
Lamontagne F, McIntyre L, Dodek P,et al. Nonleg venous thrombosis in critically ill adults:a nested prospective cohort study[J]. JAMA Intern Med,2014,174(5):689-696.
[19]
S?rensen HT, Mellemkjaer L, Olsen JH,et al.Prognosis of cancers associated with venous thromboembolism[J]. N Engl J Med,2000,343(25):1846-1850.
[20]
Seinturier C, Bosson JL, Colonna M,et al. Site and clinical outcome of deep vein thrombosis of the lower limbs:an epidemiological study[J]. J Thromb Haemost,2005,3(7):1362-1367.
[21]
Hisada Y, Mackman N. Cancer-associated pathways and biomarkers of venous thrombosis[J]. Blood,2017,130(13):1499-1506.
[22]
Schnipper LE, Davidson NE, Wollins DS,et al. American society of clinical oncology statement:A conceptual framework to assess the value of cancer treatment options[J]. J Clin Oncol,2015,33(23):2563-2577.
[23]
Nalluri SR, Chu D, Keresztes R,et al. Risk of venous thromboembolism with the angiogenesis inhibitor bevacizumab in cancer patients:a meta-analysis[J]. JAMA,2008,300(19):2277-2285.
[24]
Zwicker JI, Furie BC, Furie B. Cancer-associated thrombosis[J]. Crit Rev Oncol Hematol,2007,62(2):126-136.
[25]
Donnellan E, Kevane B, Bird BR,et al. Cancer and venous thromboembolic disease:from molecular mechanisms to clinical management[J]. Curr Oncol,2014,21(3):134-143.
[26]
Magnus N, D'Asti E, Meehan B,et al. Oncogenes and the coagulation system-forces that modulate dormant and aggressive states in cancer[J].Thromb Res,2014,133(Suppl 2):S1-9.
[27]
Zwicker JI, Liebman HA, Neuberg D,et al. Tumor-derived tissue factor-bearing microparticles are associated with venous thromboembolic events in malignancy[J]. Clin Cancer Res,2009,15(22):6830-6840.
[28]
Falanga A, Marchetti M, Vignoli A. Coagulation and cancer:biological and clinical aspects[J]. J Thromb Haemost,2013,11(2):223-233.
[29]
Samuelson Bannow BT, Konkle BA. Laboratory biomarkers for venous thromboembolism risk in patients with hematologic malignancies:A review[J]. Thromb Res,2018,163:138-145.
[30]
Pabinger I, Thaler J, Ay C. Biomarkers for prediction of venous thromboembolism in cancer[J]. Blood,2013,122(12):2011-2018.
[31]
Thaler J, Ay C, Mackman N,et al. Microparticle-associated tissue factor activity,venous thromboembolism and mortality in pancreatic,gastric,colorectal and brain cancer patients[J]. J Thromb Haemost,2012,10(7):1363-1370.
[32]
Ashrani AA, Gullerud RE, Petterson TM,et al. Risk factors for incident venous thromboembolism in active cancer patients:A population based case-control study[J]. Thromb Res,2016,139:29-37.
[33]
Khorana AA, Dalal M, Lin J,et al. Incidence and predictors of venous thromboembolism(VTE)among ambulatory high-risk cancer patients undergoing chemotherapy in the United States[J]. Cancer,2013,119(3):648-655.
[34]
Zoller B, Palmer K, Li XJ,et al. Family history of venous thromboembolism and risk of hospitalized thromboembolism in cancer patients:A nationwide family study[J]. Thromb Res,2015,136(3):573-581.
[35]
Pabinger I, Ay C, Dunkler D,et al. Factor V leiden mutation increases the risk for venous thromboembolism in cancer patients-results from the Vienna Cancer and Thrombosis Study(CATS)[J]. J Thromb Haemost,2015,13(1):17-22.
[36]
Garber JE, Halabi S, Tolaney SM,et al. Factor V leiden mutation and thromboembolism risk in women receiving adjuvant tamoxifen for breast cancer[J]. J Natl Cancer Inst,2010,102(13):942-949.
[37]
Barni S, Labianca R, Agnelli G,et al. Chemotherapy-associated thromboembolic risk in cancer outpatients and effect of nadroparin thromboprophylaxis:results of a retrospective analysis of the PROTECHT study[J]. J Transl Med,2011,9:179.
[38]
Dickmann B, Ahlbrecht J, Ay C,et al. Regional lymph node metastases are a strong risk factor for venous thromboembolism:results from the Vienna Cancer and Thrombosis Study[J]. Haematologica,2013,98(8):1309-1314.
[39]
Blom JW, Vanderschoot JP, Oostindier MJ,et al. Incidence of venous thrombosis in a large cohort of 66,329 cancer patients:results of a record linkage study[J]. J Thromb Haemost,2006,4(3):529-535.
[40]
Ahlbrecht J, Dickmann B, Ay C,et al. Tumor grade is associated with venous thromboembolism in patients with cancer:results from the Vienna cancer and thrombosis study[J]. J Clin Oncol,2012,30(31):3870-3875.
[41]
Blom JW, Doggen CJ, Osanto S,et al. Malignancies,prothrombotic mutations,and the risk of venous thrombosis[J]. JAMA,2005,293(6):715-722.
[42]
Ay C, Vormittag R, Dunkler D,et al. D-dimer and prothrombin fragment 1+2 predict venous thromboembolism in patients with cancer:results from the Vienna Cancer and Thrombosis Study[J]. J Clin Oncol,2009,27(25):4124-4129.
[43]
Agnelli G, Bolis G, Capussotti L,et al. A clinical outcome-based prospective study on venous thromboembolism after cancer surgery:the @RISTOS project[J]. Ann Surg,2006,243(1):89-95.
[44]
Cronin-Fenton DP, Sondergaard F, Pedersen LA,et al. Hospitalisation for venous thromboembolism in cancer patients and the general population:a population-based cohort study in Denmark,1997-2006[J]. Br J Cancer,2010,103(7):947-953.
[45]
Rogers MA, Levine DA, Blumberg N,et al. Triggers of hospitalization for venous thromboembolism[J]. Circulation,2012,125(17):2092-2099.
[46]
Walker AJ, West J, Card TR,et al. When are breast cancer patients at highest risk of venous thromboembolism? A cohort study using English health care data[J].Blood,2016,127(7):849-857.
[47]
Numico G, Garrone O, Dongiovanni V,et al. Prospective evaluation of major vascular events in patients with nonsmall cell lung carcinoma treated with cisplatin and gemcitabine[J]. Cancer,2005,103(5):994-999.
[48]
Kirwan CC, McCollum CN, McDowell G,et al. Investigation of proposed mechanisms of chemotherapy-induced venous thromboembolism:endothelial cell activation and procoagulant release due to apoptosis[J]. Clin Appl Thromb Hemost,2015,21(5):420-427.
[49]
Choueiri TK, Schutz FA, Je Y,et al. Risk of arterial thromboembolic events with sunitinib and sorafenib:a systematic review and meta-analysis of clinical trials[J]. J Clin Oncol,2010,28(13):2280-2285.
[50]
Lee YG, Lee E, Kim I,et al. Cisplatin-based chemotherapy is a strong risk factor for thromboembolic events in small-cell lung cancer[J]. Cancer Res Treat,2015,47(4):670-675.
[51]
Hohl Moinat C, Périard D, Grueber A,et al. Predictors of venous thromboembolic events associated with central venous port insertion in cancer patients[J]. J Oncol,2014,2014:743181.
[52]
Khorana AA, Kuderer NM, Culakova E,et al. Development and validation of a predictive model for chemotherapy-associated thrombosis[J]. Blood,2008,111(10):4902-4907.
[53]
Metcalf RL, Al-Hadithi E, Hopley N,et al. Characterisation and risk assessment of venous thromboembolism in gastrointestinal cancers[J]. World J Gastrointest Oncol,2017,9(9):363-371.
[54]
Ay C, Dunkler D, Marosi C,et al. Prediction of venous thromboembolism in cancer patients[J]. Blood,2010,116(24):5377-5382.
[55]
Verso M, Agnelli G, Barni S,et al. A modified Khorana risk assessment score for venous thromboembolism in cancer patients receiving chemotherapy:the Protecht score[J]. Intern Emerg Med,2012,7(3):291-292.
[56]
Lyman GH, Eckert L, Wang YX,et al. Venous thromboembolism risk in patients with cancer receiving chemotherapy:a real-world analysis[J]. Oncologist,2013,18(12):1321-1329.
[57]
Khorana AA, Dalal MR, Lin J,et al. Health care costs associated with venous thromboembolism in selected high-risk ambulatory patients with solid tumors undergoing chemotherapy in the United States[J]. Clinicoecon Outcomes Res,2013,5:101-108.
[58]
Farge D, Debourdeau P, Beckers M,et al. International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer[J]. J Thromb Haemost,2013,11(1):56-70.
[59]
Lee AY, Levine MN, Baker RI,et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer[J]. N Engl J Med,2003,349(2):146-153.
[60]
Woodruff S, Lee AYY, Carrier M,et al. Low-molecular-weight-heparin versus a coumarin for the prevention of recurrent venous thromboembolism in high-and low-risk patients with active cancer:a post hoc analysis of the CLOT Study[J]. J Thromb Thrombolysis,2019,47(4):495-504.
[61]
Akl EA, Kahale L, Barba M,et al. Anticoagulation for the long-term treatment of venous thromboembolism in patients with cancer[J]. Cochrane Database Syst Rev,2014(7):CD006650.
[62]
Chai-Adisaksopha C, Iorio A, Crowther MA,et al. Vitamin K antagonists after 6 months of low-molecular-weight heparin in cancer patients with venous thromboembolism[J]. Am J Med,2018,131(4):430-437.
[63]
Oo TH. Management of challenging cases of patients with cancer-associated thrombosis including recurrent thrombosis and bleeding:guidance from the SSC of the ISTH:a rebuttal[J]. J Thromb Haemost,2014,12(1):115-116.
[64]
Francis CW, Kessler CM, Goldhaber SZ,et al. Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months:the DALTECAN Study[J]. J Thromb Haemost,2015,13(6):1028-1035.
[65]
Schulman S, Kakkar AK, Goldhaber SZ,et al. Treatment of acute venous thromboembolism with dabigatran or warfarin and pooled analysis[J]. Circulation,2014,129(7):764-772.
[66]
Prins MH, Lensing AW, Bauersachs R,et al. Oral rivaroxaban versus standard therapy for the treatment of symptomatic venous thromboembolism:a pooled analysis of the EINSTEIN-DVT and PE randomized studies[J]. Thromb J,2013,11(1):21.
[67]
Agnelli G, Buller HR, Cohen A,et al. Oral apixaban for the treatment of acute venous thromboembolism[J]. N Engl J Med,2013,369(9):799-808.
[68]
Hokusai-VTE Investigators, Büller HR, Décousus H,et al. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism[J]. N Engl J Med,2013,369(15):1406-1415.
[69]
Khorana AA, Soff GA, Kakkar AK,et al. Rivaroxaban for thromboprophylaxis in high-risk ambulatory patients with cancer[J]. N Engl J Med,2019,380(8):720-728.
[70]
Carrier M, Abou-Nassar K, Mallick R,et al. Apixaban to prevent venous thromboembolism in patients with cancer[J]. N Engl J Med,2019,380(8):711-719.
[71]
Raskob GE, van Es N, Segers A,et al. Edoxaban for venous thromboembolism in patients with cancer:results from a non-inferiority subgroup analysis of the Hokusai-VTE randomized,double-blind,double-dummy trial[J]. Lancet Haematol,2016,3(8):e379-387.
[72]
Agnelli G, Buller HR, Cohen A,et al. Oral apixaban for the treatment of venous thromboembolism in cancer patients:results from the AMPLIFY trial[J]. J Thromb Haemost,2015,13(12):2187-2191.
[73]
Van der Hulle T, den Exter PL, Kooiman J,et al.Meta-analysis of the efficacy and safety of new oral anticoagulants in patients with cancer-associated acute venous thromboembolism[J]. J Thormb Haemost,2014,12(7):1116-1120.
[74]
Vedovati MC, Germini F, Agnelli G,et al. Direct oral anticoagulants in patients with VTE and cancer:a systematic review and meta-analysis[J]. Chest,2015,147(2):475-483.
[75]
Young AM, Marshall A, Thirlwall J,et al. Comparison of an oral factor Xa inhibitor with low molecular weight heparin in patients with cancer with venous thromboembolism:results of a randomized trial(SELECT-D)[J].J Clin Oncol,2018,36(20):2017-2023.
[76]
Carrier M, Cameron C, Delluc A,et al. Efficacy and safety of anticoagulant therapy for the treatment of acute cancer-associated thrombosis:a systematic review and meta-analysis[J]. Thromb Res,2014,134(6):1214-1219.
[77]
Wang TF, Zwicker JI, Ay C,et al. The use of direct oral anticoagulants for primary thromboprophylaxis in ambulatory cancer patients:guidance from the SSC of the ISTH[J].J Thromb Haemost,2019,17(10):1772-1778.
[78]
U. S. Food and Drug Administration removing retrievable inferior vena cava filters:FDA Safety Communication. 2014. Accessed August 23,2016.
[79]
中华医学会外科学分会血管外科学组.深静脉血栓形成的诊断和治疗指南(第三版)[J].中华普通外科杂志,2017,32(9):807-812.
[80]
Watson L, Broderick C, Armon MP. Thrombolysis for acute deep vein thrombosis[J]. Cochrane Database Syst Rev,2016,11:CD002783.
[81]
下肢静脉疾病外科治疗专家协作组.AngioJet机械血栓清除术治疗急性下肢深静脉血栓形成的专家共识(2016版)[J].血管与腔内血管外科杂志,2017,3(1):555-558.
[82]
Yoon WJ, Halandras P, Aulivola B,et al. Malignancy does not affect outcomes of pharmacomechanical thrombolysis in acute symptomatic iliofemoral deep vein thrombosis[J]. Ann Vasc Surg,2018,51:234-238.
[83]
Vedantham S, Goldhaber SZ, Julian JA,et al. Pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis[J].N Engl J Med,2017,377(23):2240-2252.
[84]
Kuo TT, Chen PL, Shih CC,et al. Endovascular stenting for end-stage lung cancer patients with superior vena cava syndrome post first-line treatments--a single-center experience and literature review[J]. J Chin Med Assoc,2017,80(8):482-486.
[85]
Mahnken AH, Thomson K, de Haan M,et al. CIRSE standards of practice guidelines on iliocaval stenting[J]. Cardiovasc Intervent Radiol,2014,37(4):889-897.
[86]
Vedantham S, Sista AK, Klein SJ,et al. Quality improvement guidelines for the treatment of lower-extremity deep vein thrombosis with use of endovascular thrombus removal [J].J Vasc Interv Radiol,2014,25(9):1317-1325.
[87]
Hansrani V, Khanbhai M, McCollum C. The diagnosis and management of early deep vein thrombosis[J]. Adv Exp Med Biol,2017,906:23-31.
[88]
陈千益,胡晓曼,费哲为,等.盆腔恶性肿瘤并发急性下肢深静脉血栓形成的腔内介入治疗(附32例)[J].现代肿瘤学,2018,26(4):612-616.
[89]
Ierardi AM, Jannone ML, Petrillo M,et al. Treatment of venous stenosis in oncologic patients[J].Future Oncol,2018,14(28):2933-2943.
[90]
Enden T, Klow NE, Sandvik L,et al. Catheter-directed thrombolysis vs.anticoagulant therapy alone indeep vein thrombosis:results of an open randomized,controlled trialreporting on short-term patency[J].J Thromb Haemoat,2009,7(8):1268-1275.
[91]
Vedantham S. Deep venous thrombosis:the opportunity at hand[J]. AJR Am J Roentgenol,2009,193(4):922-927.
[92]
李文会,戴真煜,万豪光,等.125I粒子条联合门静脉支架及TACE序贯索拉菲尼治疗肝癌合并门静脉主干癌栓[J].中华医学杂志,2016,96(23):1838-1842.
[93]
余天柱,罗剑钧,颜志平.血管内近程放疗与序贯三维适形放疗治疗门静脉主干癌栓的疗效对比[J].介入放射学杂志,2017,26(9):787-792.
[94]
Yao LH, Su L, Liu L,et al. Stenting of the portal vein combined with different numbers of iodine-125 seed strands:dosimetric analyses[J]. Chin Med J,2017,130(18):2183-2189.
[95]
武京鹏,何东风.125I粒子条植入治疗原发性肝癌伴门静脉主干癌栓的近期疗效[J].中华介入放射学电子杂志,2015,3(3):144-147.
[96]
郝红军,张兴仕,金鑫,等.支架联合125I粒子条植入治疗肝癌所致下腔静脉恶性梗阻20例[J].介入放射学杂志,2016,25(6):538-542.
[97]
杨清慧,张雯,颜志平,等.植入放射性支架联合经动脉化疗栓塞(TACE)治疗肝恶性肿瘤合并下腔静脉(IVC)梗阻[J].复旦学报(医学版),2014,41(5):617-623.
[98]
Gong M, Song J, He X,et al. Intraluminal brachytherapy using a self-expandable stent loaded with linear iodine-125 seeds in a patient with reiterative recurrence of cancer-associated vein obstruction:acase report with 3 months of follow-up[J]. Vasc Endovascular Surg,2018,52(6):463-468.
[1] 刘银凤, 袁关利, 马力. PER基因家族在恶性肿瘤中的研究进展[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(01): 40-46.
[2] 吴姗姗, 潘裕民, 刘晋, 张劲松, 乔莉. 睡眠呼吸暂停综合征患者静脉血栓栓塞症发生率的Meta分析[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(04): 312-317.
[3] 姚金含, 王伟娜, 张玉泉. 妊娠相关深静脉血栓形成患者的预后研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(04): 367-373.
[4] 黄鸿初, 黄美容, 温丽红. 血液系统恶性肿瘤患者化疗后粒细胞缺乏感染的危险因素和风险预测模型[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(05): 285-292.
[5] 严华悦, 刘子祥, 周少波. 磷酸烯醇式丙酮酸羧激酶-1在恶性肿瘤中的研究进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 452-456.
[6] 李国煜, 丛赟, 祖丽胡马尔·麦麦提艾力, 何铁英. 急性胰腺炎并发门静脉系统血栓形成的危险因素及预测模型构建[J/OL]. 中华普通外科学文献(电子版), 2024, 18(04): 266-270.
[7] 牛斌, 饶兰英, 娜迪拉·哈孜肯尼, 何龙林, 刘晓晨, 蒋波. 两样本孟德尔随机化分析阑尾切除与结直肠肛管恶性肿瘤发生风险的关系[J/OL]. 中华普通外科学文献(电子版), 2024, 18(01): 29-33.
[8] 陈杨, 李茜, 杨中华. 慢性阻塞性肺疾病急性加重期合并VTE抗凝治疗的研究进展[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(02): 316-319.
[9] 危用洋, 黄俊甫, 辛万鹏, 易思清, 涂书举, 方康, 李勇, 肖卫东. 三种术式治疗胰腺颈体部良性或低度恶性肿瘤的临床疗效分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 515-519.
[10] 辛万鹏, 黄俊甫, 肖卫东. 机器人保留器官功能的胰腺切除术临床应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 461-465.
[11] 牛斌, 饶兰英, 刘晓晨, 何龙林, 秦培鑫. 基于孟德尔随机化分析胆囊切除与结直肠肛管恶性肿瘤发生的关系[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(03): 313-318.
[12] 于洁, 金小红, 顾艳楣, 王慧, 葛杨杨, 李燕. 癌症相关静脉血栓栓塞症患者疾病体验与需求的质性研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 739-744.
[13] 彭小蓉, 莫伟, 李琴, 吴雅琴, 李兰. 妊娠期妇女静脉血栓栓塞症预防的知信行现状及其影响因素分析[J/OL]. 中华介入放射学电子杂志, 2024, 12(03): 274-280.
[14] 李兰, 向华, 莫伟, 胡琴, 李琴, 吴雅琴, 李玉莲, 彭小蓉. 社区老年人静脉血栓栓塞症认知水平的调查研究[J/OL]. 中华介入放射学电子杂志, 2024, 12(01): 75-81.
[15] 王思奇, 张念荣, 周彪, 刘宝胤, 孟化. 肥胖与胆囊疾病研究进展[J/OL]. 中华肥胖与代谢病电子杂志, 2024, 10(03): 177-183.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?