Kalmanti Maria, Germanakis John, Stiakaki Eftichia, Syfridaki Cathrin, Christidou Athanasia, Tsetis Dimitris, Vardas Panagiotis, Charisis George
Department of Pediatric Hematology/Oncology, University Hospital of Heraklion, Crete, Greece.
Pediatr Hematol Oncol. 2002 Apr-May;19(3):173-9. doi: 10.1080/088800102753541323.
This study evaluated the effects of urokinase in the prevention of central venous catheter (CVC)-related complications in children with malignancy. Fifteen patients with 16 CVCs (study group A) received an intraluminal application of urokinase (10,000 IU in each catheter lumen for 4 h) once a week. They were monitored prospectively with quantitative blood cultures and ultrasonography (color Doppler ultrasound of the great veins and echocardiography). The rate of complications was compared with that of 15 children with 19 CVCs without thromboprophylaxis, treated the previous significantly lower incidence of CVC dysfunction year (control group B). The authors found a wer incidence of CVC dysfunction (3/16 versus 13/19), no major thrombosis, fewer CVC-related bacteremias (2/16 versus 8/19), and a higher salvage of CVCs (1/16 versus 5/19 CVC removals due to persistent bacteremia) in the thromboprophylaxis group. Asymptomatic thrombosis rate was also lower (7/16 cases in group A versus 9/11 in group B when sonography was performed). No hemorrhagic complications were noted. Thromboprophylaxis with urokinase seems a safe and effective measure for reducing the rate of CVC-related complications.
本研究评估了尿激酶在预防恶性肿瘤患儿中心静脉导管（CVC）相关并发症中的作用。15例患儿共16根CVC（研究组A），每周一次在管腔内应用尿激酶（每根导管管腔10000 IU，持续4小时）。通过定量血培养和超声检查（大静脉彩色多普勒超声和超声心动图）对他们进行前瞻性监测。将并发症发生率与前一年接受治疗的15例未进行血栓预防的患儿（19根CVC）（对照组B）进行比较。作者发现，血栓预防组CVC功能障碍发生率较低（3/16对13/19），无严重血栓形成，CVC相关菌血症较少（2/16对8/19），CVC挽救率较高（因持续性菌血症导致的CVC拔除率为1/16对5/19）。无症状血栓形成率也较低（进行超声检查时，A组为7/16例，B组为9/11例）。未观察到出血并发症。尿激酶预防血栓形成似乎是降低CVC相关并发症发生率的一种安全有效的措施。
