Axelsson C K, Efsen F
Scand J Gastroenterol. 1978;13(8):933-8. doi: 10.3109/00365527809181371.
The frequency of superior central venous thrombosis was studied in a consecutive retrospective series of 27 patients with severe gastrointestinal disorders in whom long-term catheterization of the subclavian vein for parenteral nutrition was carried out. The patients had 35 periods of catheterization ranging from 14 to 766, mean 86, days and a total of 51 catheter periods. Only one patient showed clinical signs of thrombosis in spite of phlebographic findings revealing seven cases of central venous thrombosis. Recanalization was not seen. Exchange of catheter was performed 17 times in 10 patients using the Seldinger technique. This did not influence thrombosis rate. Septicaemia was found in five patients subsiding after catheter exchange. No fatalities occurred, and no correlation between the septicaemia and thrombosis rate was found. Catheters used for more than 100 days showed changes of mechanical properties. It is therefore advisable to exchange catheters after 3 months' use by the Seldinger technique. The discrepancy between the clinical and phlebographic findings emphasizes that repeated subclavian catheterization should be preceded by bilateral phlebography.
对连续27例患有严重胃肠道疾病且接受锁骨下静脉长期置管进行肠外营养的患者进行回顾性研究，以探讨上腔静脉血栓形成的发生率。这些患者进行了35次置管，时间从14天至766天不等，平均86天，总计51个导管留置期。尽管静脉造影结果显示有7例中心静脉血栓形成，但只有1例患者出现了血栓形成的临床症状。未见再通情况。10例患者使用Seldinger技术进行了17次导管更换。这并未影响血栓形成率。5例患者发生败血症，在更换导管后消退。未发生死亡病例，且未发现败血症与血栓形成率之间存在相关性。使用超过100天的导管显示出机械性能的改变。因此，建议在使用3个月后通过Seldinger技术更换导管。临床和静脉造影结果之间的差异强调，在反复进行锁骨下静脉置管之前应先进行双侧静脉造影。
