Zorzanello Mary M, Fleming Warren J, Prowant Barbara E
Gambro Health Care New Haven, the primary dialysis affiliate of Yale School of Medicine in New Haven, CT, USA.
Nephrol Nurs J. 2004 Sep-Oct;31(5):534-7.
There have been anecdotal reports of the use of tPA for obstructed peritoneal dialysis catheters in both adults and children. This manuscript reviews the literature and summarizes common elements of the procedures used for tPA administration in peritoneal dialysis catheters. The Gambro New Haven experience with administration of tPA (8 mgs in 10 ml of sterile water injected into the catheter and allowed to dwell for 1 hour) in 29 cases of catheter obstruction in 18 patients is presented. Patency was restored in 24 instances with no adverse effects. In the 5 cases that did not respond, the primary cause of poor drain was catheter malposition in 2, constipation in 2, and adhesions in 1. tPA was also administered to 5 patients with relapsing peritonitis; 3 patients, all with Staphylococcus epidermidis, recovered and did not experience further recurrence.
已有关于成人和儿童使用组织型纤溶酶原激活剂（tPA）治疗腹膜透析导管堵塞的轶事报道。本文回顾了文献，并总结了在腹膜透析导管中使用tPA的常见操作要点。介绍了甘布罗纽黑文医院在18例患者的29例导管堵塞中使用tPA（8毫克溶于10毫升无菌水中注入导管并保留1小时）的经验。24例恢复了通畅，无不良反应。在5例无反应的病例中，引流不畅的主要原因是2例导管位置不当、2例便秘和1例粘连。5例复发性腹膜炎患者也接受了tPA治疗；3例患者均为表皮葡萄球菌感染型，康复且未再次复发。
