Hsu Hui-Fang, Chou Yi-Hung, Wang Chao-Ran, Wu Shu-Chuan
Division of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital, Taipei.
Chang Gung Med J. 2003 Oct;26(10):782-6.
A premature infant experienced respiratory distress due to chylothorax. Contrast-enhanced chest computed tomography showed superior vena cava (SVC) obstruction with collaterals, and surgery confirmed an obstruction of the SVC by intravascular fibrotic tissue and thrombi caused by placement of a central venous catheter. The respiratory distress improved after surgical intervention. In the differential diagnosis of acute respiratory distress, it is necessary to consider catheter-related chylothorax and SVC syndrome when a previously stable patient has an acute change in cardiopulmonary status, regardless of the duration of catheter use. Although often considered safe and easy, central venous catheter placement may result in complications. Using appropriate catheters and choosing proper insertion sites can minimize these events. Early diagnosis and treatment can be life-saving should complications occur.
一名早产儿因乳糜胸出现呼吸窘迫。增强胸部计算机断层扫描显示上腔静脉(SVC)阻塞并伴有侧支循环,手术证实SVC被中心静脉导管置入引起的血管内纤维化组织和血栓阻塞。手术干预后呼吸窘迫得到改善。在急性呼吸窘迫的鉴别诊断中,当先前病情稳定的患者心肺状态发生急性变化时,无论导管使用时间长短,都有必要考虑导管相关乳糜胸和SVC综合征。尽管中心静脉导管置入通常被认为安全简便,但仍可能导致并发症。使用合适的导管并选择恰当的插入部位可将这些事件的发生降至最低。一旦发生并发症,早期诊断和治疗可挽救生命。