Lankveld D P, Ensink J M, van Dijk P, Klein W R
Department of Equine Sciences, Faculty of Veterinary Medicine, Universiteit Utrecht, The Netherlands.
J Vet Med A Physiol Pathol Clin Med. 2001 Nov;48(9):545-52. doi: 10.1046/j.1439-0442.2001.00383.x.
Thrombophlebitis is a well-known complication of the use of long-term in-dwelling catheters. In humans, catheter material has been shown to strongly influence the occurrence of thrombophlebitis. In the horse, the influence of catheter material has been studied in healthy experimental animals, but information on the relative importance of this factor is lacking. To investigate which factors have most impact on the frequency of jugular vein thrombosis in post-surgical colic horses, a clinical study was performed on 38 animals. Horses were randomly divided into two groups. In one group a polytetrafluoroethylene catheter was used, in the other a polyurethane catheter. Both groups were clinically monitored and screened for signs of thrombophlebitis. Seven out of 38 horses developed thrombophlebitis. The type of catheter material used had no influence on thrombophlebitis development. Dwell time was significantly longer in horses that developed thrombophlebitis compared with those that did not. There was no relationship between the occurrence of thrombophlebitis and underlying disease or surgical treatment, suggesting that the general state of debilitation these horses experienced was the most important determinant for the development of thrombophlebiris. This was further stressed by the fact that seven horses developed thrombophlebitis of the contralateral vein that had been used for the induction of anaesthesia (this incidence is much higher than in horses anaesthetized for elective surgery). It is concluded that the state of debilitation is the most important determining factor for the occurrence of thrombophlebitis after the use of long-term in-dwelling intravenous catheters. This makes a substantial reduction of the incidence of thrombophlebitis difficult, but some progress can be made by consequently restricting dwell time.
血栓性静脉炎是长期留置导管使用中一种众所周知的并发症。在人类中,已表明导管材料对血栓性静脉炎的发生有很大影响。在马身上,已在健康实验动物中研究了导管材料的影响,但缺乏关于该因素相对重要性的信息。为了调查哪些因素对术后急腹症马颈静脉血栓形成的频率影响最大,对38只动物进行了一项临床研究。马被随机分为两组。一组使用聚四氟乙烯导管,另一组使用聚氨酯导管。两组均进行临床监测并筛查血栓性静脉炎的迹象。38匹马中有7匹发生了血栓性静脉炎。所用导管材料的类型对血栓性静脉炎的发展没有影响。发生血栓性静脉炎的马的留置时间明显长于未发生血栓性静脉炎的马。血栓性静脉炎的发生与潜在疾病或手术治疗之间没有关系,这表明这些马所经历的衰弱总体状态是血栓性静脉炎发展的最重要决定因素。七匹马对侧用于诱导麻醉的静脉发生了血栓性静脉炎这一事实进一步强调了这一点(该发生率远高于择期手术麻醉的马)。得出的结论是,衰弱状态是长期留置静脉导管后血栓性静脉炎发生的最重要决定因素。这使得大幅降低血栓性静脉炎的发生率变得困难,但通过严格限制留置时间可以取得一些进展。