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目的 本文旨在探讨乳腺癌患者围手术期猝死的可能原因 ,诊断和治疗方法。方法 回顾性分析 195 8年～ 1997年乳腺癌围手术期猝死的 5例患者临床资料。结果 乳腺癌围手术期猝死发生率为 0 .13 % ,近年为 0 .5 1%。其危险因素为Trausseau’ssyndrome所致的致死性栓塞性疾病 ,如肺栓塞、急性心肌梗塞。诊断通过血小板激活 ,血液凝固激活和血栓形成伴有的纤维溶解激活的检测及静脉多普勒扫描和静脉造影。运用弹性袜、充气腓肠肌压迫器、皮下经射肝素、低分子量肝素等可预防 ,联合应用效果更佳。治疗 :抗凝 ,溶栓 ,手术和下腔静脉滤器。结论 关键在于对该病的正确认识 ,尽早明确诊断和有效地治疗。
Objective This article aims to investigate the possible causes, diagnosis and treatment of sudden death in patients with breast cancer. Methods The clinical data of 5 patients who died of perioperative breast cancer during 195 to 1998 were analyzed retrospectively. Results The incidence of sudden death in perioperative period of breast cancer was 0.13%, and 0.5% in recent years. The risk factors are fatal embolic diseases caused by Trausseau’s syndrome, such as pulmonary embolism and acute myocardial infarction. The diagnosis is through platelet activation, blood coagulation activation and detection of fibrinolytic activation associated with thrombosis, and intravenous Doppler scanning and venography. The use of elastic socks, inflatable gastrocnemius compressor, subcutaneous heparin, low molecular weight heparin, etc. can be prevented and combined with better results. Treatment: anticoagulation, thrombolysis, surgery and inferior vena cava filters. Conclusion The key lies in the correct understanding of the disease, as soon as possible, a clear diagnosis and effective treatment.