婦癌與血管栓塞

Gynecologic cancer and venous thromboembolism

靜脈栓塞是婦癌手術後易發生的併發症、甚至致死，特別在骨盆腔手術，下肢靜脈和骨盆腔靜脈有栓塞高風險。在晚期或有轉移性病灶的婦癌患者，尤以卵巢癌者發生機率最高。婦癌手術前便開始給予抗凝血藥物來預防靜脈栓塞在歐美已行之有年，成效好、副作用少。而對飲食習慣已西化的台灣婦女，婦癌醫師應熟稔抗凝血藥物之運用，才有利於患者及自己。

Venous thromboembolism is a major source of morbidity and mortality for gynecologic oncology patients. This increased risk for pelvic surgery patients is secondary to emboli that can arise from the lower extremities as well as the pelvic veins. Furthermore, as cancer is a heterogeneous disease, the risk of venous thrombosis depends on cancer types and stages, treatment measures, and patient-related factors. Because venous thromboembolism can begin intraoperatively, preoperative administration of pharmacologic prophylaxis is likely beneficial without significant harms for gynecologic oncology patients. However, optimal anticoagulation in such instances presents a major challenge to gynecologic oncologist.