Đặc điểm lâm sàng thuyên tắc huyết khối tĩnh mạch ở người bệnh ung thư cao tuổi tại Khoa lão - Chăm sóc giảm nhẹ Bệnh viện Đại Học Y Dược Thành Phố Hồ Chí Minh

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Tác giả: Ngọc Hoành Mỹ Tiên Nguyễn, Thị Phương Lan Nguyễn, Thị Bích Hà Trịnh

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Y học lâm sàng Bệnh viện Trung ương Huế, 2023

Mô tả vật lý: tr.60-66

Bộ sưu tập: Metadata

ID: 369795

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ABSTRACT CHARACTERISTICS OF VENOUS THROMBOEMBOLISM AMONG OLDER ADULTS WITH CANCER AT GERIATRICS AND PALLIATIVE CARE DEPARTMENT, UNIVERSITY MEDICAL CENTER AT HO CHI MINH CITY Nguyen Ngoc Hoanh My Tien1,2, Trinh Thi Bich Ha1,2, Nguyen Thi Phuong Lan3 Objective: This study aimed to assess the prevalence and clinical, paraclinical features of VTE in older adults with diagnosis of cancer at Geriatrics and Palliative care department in University Medical Center at Ho Chi Minh city. Methods: A retrospective study was conducted in 1,167 medical records of older inpatients (≥ 60 years old) with diagnosis of cancer, at Geriatrics and Palliative care department in UMC, from 01/01/2016 to 31/12/2020. Data on demographic, social, clinical aspects, treatments and adverse effects were collected. Results: The prevalence of older adults having cancers was 12.9% (151), with 3,8% (44) of deep VTE of the lower extremities and 3,9% (46) of pulmonary embolism. Infection, hypertension, chronic kidney disease and diabetes type 2 were the most common comorbidities. Liver, lung and colorectal cancers were the most popular cancer. Among deep VTE of the lower extremity clinical symptoms, leg swelling (61.3%) and footsore (59%) were the most common, while the prevalence of deep VTE of left leg was higher (56.8%). In addition, dyspnea (80.4%) and tachycardia (71.7%) are the most popular symptoms of pulmonary embolism. Conclusions: The prevalence of VTE was high in clinical practice. Therefore, doctors should pay attention in order to have strategies for prevention during hospital stay. However, clinical, paraclinical features of VTE were atypical and nonspecific. In practice, doctors should evaluate the risk factors of VTE and choose suitable scoring measurement to have appropriate strategies.Mục tiêu: Khảo sát tỷ lệ, đặc điểm lâm sàng và cận lâm sàng của TTHKTM ở NCT mắc ung thư, tại khoa Lão - Chăm sóc giảm nhẹ, bệnh viện Đại học Y Dược thành phố Hồ Chí Minh. Đối tượng, phương pháp: Nghiên cứu hồi cứu, tiến hành trên 1167 hồ sơ bệnh án NCT (≥ 60 tuổi) bệnh ung thư, điều trị nội trú tại khoa Lão - Chăm sóc giảm nhẹ từ ngày 01/01/2016 đến 31/12/2020, bệnh viện Đại học Y Dược thành phố Hồ Chí Minh. Chúng tôi thu thập các đặc điểm dân số, bệnh lý, lâm sàng và cận lâm sàng của TTHKTM của NCT bị ung thư. Kết quả: Tỷ lệ TTHKTM chung của NCT mắc ung thư là 12,9% (151), trong đó huyết khối tĩnh mạch sâu chi dưới (HKTMSCD) là 3,8% (44), thuyên tắc phổi (TTP) là 3,9% (46). Nhiễm trùng, tăng huyết áp, bệnh thận mạn, đái tháo đường típ 2 là các bệnh đồng mắc thường gặp nhất. Ung thư gan, phổi, đại trực tràng là 3 loại ung thư có tỉ lệ cao nhất. Trong HKTMSCD, phù chân (61,4%), đau chân (59,1%) là 2 triệu chứng hay gặp nhất với HKTMSCD ở chân trái chiếm ưu thế (56,8%). Trong khi đó, khó thở, nhịp tim nhanh chiếm tỷ lệ 80,4% và 71,7% cao nhất trong TTP. Kết luận: Tỉ lệ TTHKTM khá cao nên trong thực hành lâm sàng thầy thuốc cần quan tâm đến vấn đề này để có chiến lược phòng ngừa trong thời gian nằm viện và có chỉ định cận lâm sàng phù hợp. Tuy nhiên, các đặc điểm lâm sàng, cận lâm sàng khá nghèo nàn, không điển hình, không nhạy và đặc hiệu nên trong thực hành cần đánh giá nguy cơ TTHKTM và các bảng điểm để có chiến lược xử trí thích hợp.

1. Đọc trực tuyến

1. Đọc trực tuyến

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