van Ommen C H, Heijboer H, Büller H R, Hirasing R A, Heijmans H S, Peters M
Department of Pediatrics, Emma Children's Hospital AMC, Amsterdam, The Netherlands.
J Pediatr. 2001 Nov;139(5):676-81. doi: 10.1067/mpd.2001.118192.
To study the incidence, signs and symptoms, diagnostic tests, risk factors, therapy, and complications of pediatric venous thromboembolism (VTE) in The Netherlands.
A prospective 2-year registry of VTE in children aged < or = 18 years.
Ninety-nine patients were registered. The annual incidence of VTE was 0.14/10,000 children, 35% of whom were symptom free. Almost half of the patients were newborns. Neonatal VTE was almost exclusively catheter related, located in the upper venous system, and asymptomatic. In older children VTE was catheter related in approximately one third and more often was located in the lower venous system. In 85% of all patients, thrombosis developed while the patient was in the hospital. Diagnosis was usually made by ultrasonography. In 98% of all patients, at least 1 risk factor was present. Congenital prothrombotic disorders were more often present in older children (21%) than in neonates (6%). A variety of treatment modalities were used. Morbidity consisted of bleeding (7%) and recurrent thrombosis (7%). Two children died as result of VTE.
VTE is mostly diagnosed in hospitalized children, especially sick newborns with central venous catheters and older children with a combination of risk factors. Primary prevention, optimal treatment, and long-term outcome of pediatric symptomatic and asymptomatic VTE need to be studied.
研究荷兰儿童静脉血栓栓塞症（VTE）的发病率、体征和症状、诊断测试、危险因素、治疗方法及并发症。
对18岁及以下儿童的VTE进行为期2年的前瞻性登记。
登记了99例患者。VTE的年发病率为0.14/10000名儿童，其中35%无症状。几乎一半的患者为新生儿。新生儿VTE几乎均与导管相关，位于上静脉系统，且无症状。年龄较大儿童的VTE约三分之一与导管相关，且更常位于下静脉系统。所有患者中85%在住院期间发生血栓形成。诊断通常通过超声检查。所有患者中98%至少存在1个危险因素。先天性血栓形成倾向疾病在年龄较大儿童中（21%）比在新生儿中（6%）更常见。采用了多种治疗方式。并发症包括出血（7%）和复发性血栓形成（7%）。两名儿童死于VTE。
VTE大多在住院儿童中被诊断出来，尤其是患有中心静脉导管的患病新生儿以及具有多种危险因素的年龄较大儿童。需要研究儿童有症状和无症状VTE的一级预防、最佳治疗方法及长期预后。
