肿瘤病人凝血与止血的障碍常伴有血栓出血性综合征,并常与肿瘤生长平行发展。它是恶性肿瘤特点之一。早在1865年Tpycco就指出胃癌病人伴有下肢静脉血栓形成,并认为血栓性静脉炎可能是潜伏进行的恶性肿瘤的首发症状。[发生率]近年报道的资料表明,10～30%肿瘤病人可发生各种血栓并发症,并占术后死因的第2、3位。血栓栓塞性并发症常发生于胃、肺、食道、肠与胰腺、子宫和其他部位的恶性肿瘤。利用十分敏感的放射性同位素标记纤维蛋白原方法确定了肿瘤病人术后下肢静脉血栓形成的发生率高达50～55%,比其他外科手术病人高1倍。即使40岁以下癌肿病人术后发生下肢深部静脉血栓形成(34.6%)也高于其他外科手术的40岁以上病人(25%)。恶性肿瘤死亡的病人45～55%肺动脉可见血栓栓塞性病变。作为恶性肿瘤这常见的并发症的矛盾是:血管内血栓形成同时发生或随后发生的病理性出血,但其发病机制是统一的。根据Шулъга的资料,死于恶性肿瘤的病人14.3%可见血栓与出血并发症并存,并有4.4%病人的主要死因是低纤维蛋白血症与纤溶亢进所致的出血。首先报道类似出血症状的是Jurgens等人(1930),他们描述了1例前列腺癌骨转移病人发生大出血。随后许多作者报道发生出血性紫癜的肿瘤有:黑色素瘤、支气管、肺、胃、胰腺、结肠等癌症。在肿瘤发展时常观察到血栓合并症与出血性紫癜同时出现。如Bagnod观 Tumor patients with coagulation and hemostasis often accompanied by thrombotic hemorrhagic syndrome, and often parallel with tumor growth. It is one of the hallmarks of malignancy. As early as 1865, Tpycco pointed out that patients with gastric cancer were accompanied by venous thrombosis of the lower extremities and believed that thrombophlebitis might be the first symptom of a latent malignancy. [Incidence] reported in recent years, the data show that 10 to 30% of tumor patients can occur a variety of thrombotic complications, and accounted for postoperative causes of the first 2,3. Thromboembolic complications often occur in the stomach, lung, esophagus, intestine and pancreas, uterus and other malignancies. The use of a very sensitive radioisotope labeled fibrinogen method to determine the incidence of postoperative venous thrombosis in patients with up to 50 ~ 55%, 1 times higher than other surgical patients. Even patients under 40 years of age developed postoperative deep venous thrombosis of the lower extremities (34.6%) compared with other surgeries (25%) older than 40 years. Malignant tumor patients 45 ~ 55% pulmonary thromboembolic lesions. As a common complication of malignant tumors, the paradox is that there are pathological hemorrhages that occur concurrently with or subsequent to intravascular thrombosis, but the pathogenesis is uniform. According to Шулъга, 14.3% of the patients who died of malignant tumor showed the coexistence of thrombosis and bleeding complications, and 4.4% of the patients died of bleeding due to hypofibrinia and fibrinolysis. One of the first reports of bleeding-like symptoms was Jurgens et al. (1930), who described a major bleeding in 1 patient with prostate cancer bone metastases. Subsequently, many authors report that hemorrhagic purpura tumors are: melanoma, bronchial, lung, stomach, pancreas, colon and other cancers. Thrombosis and hemorrhagic purpura are often seen in the development of tumors. As Bagnod view