Dounas M, Yamami A, Peillon P, Martinais P, Angenard F
Service d'anesthésie-réanimation (Dr. Y Guittard), centre hospitalier général de Lagny-Marne-la-Vallée, 31, avenue du Général-Leclerc, 77405 Lagny, France.
Ann Fr Anesth Reanim. 2000 Nov;19(9):684-7. doi: 10.1016/s0750-7658(00)00298-7.
Thrombosis originating from the tip of central venous catheter is a well known complication. The calcification of such a thrombus is very rare. Until now, only two cases had been described with long-term indwelling central venous catheters used for total parenteral nutrition. We report the first case of a calcified thrombus occurred during a short-term central venous catheterisation. The presumptive mechanism of thrombus calcification is precipitation of calcium salts and its deposition on a pre-existent thrombus. In total parenteral nutrition the mechanism of calcification seems to be multifactorial. Thus, the precipitation of calcium phosphate is increased by the following factors: higher calcium and phosphate concentrations, the use of calcium chloride instead of calcium gluconate, lower pH solutions, slow infusion rate.
源于中心静脉导管尖端的血栓形成是一种众所周知的并发症。这种血栓的钙化非常罕见。到目前为止，仅有两例使用长期留置中心静脉导管进行全胃肠外营养的病例被描述。我们报告了第一例在短期中心静脉置管期间发生的钙化血栓病例。血栓钙化的推测机制是钙盐沉淀并沉积在已存在的血栓上。在全胃肠外营养中，钙化机制似乎是多因素的。因此，磷酸钙沉淀会因以下因素而增加：较高的钙和磷浓度、使用氯化钙而非葡萄糖酸钙、较低pH值的溶液、缓慢的输注速度。
