Mehta S, Connors A F, Danish E H, Grisoni E
Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH 44109.
J Pediatr Surg. 1992 Jan;27(1):18-22. doi: 10.1016/0022-3468(92)90095-o.
Forty-two newborns were studied prospectively to determine the incidence of thrombosis due to central venous catheterization. Following Broviac catheter placement, the catheter tip, distal superior vena cava, and right atrium were evaluated by weekly two-dimensional echocardiograms. The presence of thrombosis was examined in relation to birth weight, gestational age, age and weight at the time of catheter placement, antithrombin III levels, and platelet counts. Six newborns (14%) were noted to have a thrombus by echocardiographic examination after the catheter had been in place for a median duration of 7 weeks. The infants with thrombus formation had significantly lower birth weights (887 +/- 231 v 1,409 +/- 766 g; P = .003) and gestational ages (27 +/- 2.4 v 30.3 +/- 4.3 weeks; P = .018) than those without thrombus. Their weights (757 +/- 203 v 1,832 +/- 1,098 g; P = .000) and ages (2.75 +/- 0.76 v 7.24 +/- 7.8 weeks; P = .002) at the time of catheter placement were also lower; the antithrombin III levels were lower at the time of catheter placement (0.32 +/- 0.08 v 0.06 +/- 0.31 U/mL; P = .001), but were normal for gestational and postnatal age. The presence of thrombosis was not related to the sex of the baby, the platelet count, or the duration of catheterization.
对42例新生儿进行前瞻性研究，以确定中心静脉置管导致血栓形成的发生率。在置入Broviac导管后，每周通过二维超声心动图评估导管尖端、上腔静脉远端和右心房。研究了血栓形成与出生体重、胎龄、置管时的年龄和体重、抗凝血酶III水平及血小板计数之间的关系。在导管置入中位时间为7周后，通过超声心动图检查发现6例新生儿（14%）有血栓形成。有血栓形成的婴儿出生体重（887±231 vs 1409±766 g；P = 0.003）和胎龄（27±2.4 vs 30.3±4.3周；P = 0.018）显著低于无血栓形成的婴儿。他们置管时的体重（757±203 vs 1832±1098 g；P = 0.000）和年龄（2.75±0.76 vs 7.24±7.8周；P = 0.002）也较低；置管时抗凝血酶III水平较低（0.32±0.08 vs 0.06±0.31 U/mL；P = 0.001），但对于胎龄和出生后年龄来说是正常的。血栓形成与婴儿性别、血小板计数或置管持续时间无关。
